Long-term survival and prognostic factors in extragonadal germ cell tumors: a 30-year experience at a single institution.

IF 2.5 3区医学 Q2 ONCOLOGY

Clinical & Translational Oncology Pub Date : 2025-10-01 Epub Date: 2025-04-30 DOI:10.1007/s12094-025-03904-2

Patricia Capdevila, Cristobal Carrasco, Elisa Gómez, Carlos Escrivá, Emilio Soria, Josep M Esteve, Jorge Aparicio Urtasun

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引用次数: 0

Abstract

Purpose: Extragonadal germ cell tumors (EGCT) are rare malignancies, typically located in midline structures, with treatment consisting of cisplatin-based chemotherapy. We aimed to evaluate long-term outcomes, identify prognostic factors and assess treatment efficacy.

Methods: We retrospectively evaluated 31 patients with EGCT between 1994 and 2024. RStudio was used for data analysis. Progression free survival (PFS) and overall survival (OS) was assessed using Kaplan-Meier, and prognostic factors via Cox regression. Approval was obtained from our local Ethics Committee.

Results: The most common site was mediastinum (59%), followed by retroperitoneum and central nervous system. Non-seminomatous germ cell tumors (NSGCT) were more frequent than seminomas (61% vs. 39%), and 41% of patients had metastasis at diagnosis. After first-line chemotherapy plus selective surgery or irradiation, the disease control rate was 81%. Progression or relapse occurred in 48% of patients, mostly in those with mediastinal NSGCT. No secondary malignancies were detected during follow-up. 5- and 10-year OS were 70%. NSGCT histology and mediastinal location were significantly associated with lower survival, with a 5-year OS of 34% in mediastinal NSGCT.

Conclusions: While cisplatin-based chemotherapy remains effective for EGCT patients, mediastinal NSGCT pose significant challenges, highlighting the need for improved strategies.

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生殖道外生殖细胞肿瘤的长期生存和预后因素：在单一机构的30年经验。

目的：生殖道外生殖细胞肿瘤（EGCT）是一种罕见的恶性肿瘤，通常位于中线结构，治疗包括以顺铂为基础的化疗。我们的目的是评估长期结果，确定预后因素并评估治疗效果。方法：回顾性评价1994年至2024年间31例EGCT患者。使用RStudio进行数据分析。采用Kaplan-Meier法评估无进展生存期（PFS）和总生存期（OS），采用Cox回归法评估预后因素。获得了我们当地伦理委员会的批准。结果：最常见部位为纵隔（59%），其次为腹膜后和中枢神经系统。非精原细胞生殖细胞瘤（NSGCT）比精原细胞瘤更常见（61%比39%），41%的患者在诊断时有转移。经一线化疗加选择性手术或放疗后，疾病控制率为81%。48%的患者出现进展或复发，主要发生在纵隔NSGCT患者。随访期间未发现继发性恶性肿瘤。5年和10年生存率为70%。NSGCT的组织学和纵隔位置与较低的生存率显著相关，纵隔NSGCT的5年OS为34%。结论：虽然以顺铂为基础的化疗对EGCT患者仍然有效，但纵隔NSGCT带来了重大挑战，突出了改进策略的必要性。

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来源期刊

Clinical & Translational Oncology 医学-肿瘤学

CiteScore

6.20

自引率

2.90%

发文量

240

审稿时长

1 months

期刊介绍： Clinical and Translational Oncology is an international journal devoted to fostering interaction between experimental and clinical oncology. It covers all aspects of research on cancer, from the more basic discoveries dealing with both cell and molecular biology of tumour cells, to the most advanced clinical assays of conventional and new drugs. In addition, the journal has a strong commitment to facilitating the transfer of knowledge from the basic laboratory to the clinical practice, with the publication of educational series devoted to closing the gap between molecular and clinical oncologists. Molecular biology of tumours, identification of new targets for cancer therapy, and new technologies for research and treatment of cancer are the major themes covered by the educational series. Full research articles on a broad spectrum of subjects, including the molecular and cellular bases of disease, aetiology, pathophysiology, pathology, epidemiology, clinical features, and the diagnosis, prognosis and treatment of cancer, will be considered for publication.