Extragonadal germ cell tumors in Taiwan: An analysis of treatment results of 59 patients

BACKGROUND. Extragonadal germ cell tumors (EGCT) are rare. They are biologically distinct from their testicular counterparts. Information regarding these tumors from the Far East is limited. More investigations are warranted to define the optimal treatment. METHODS. Retrospective review of the medical records of 59 patients with EGCT treated between 1983 and 2001 at a large, tertiary care institute in Taipei. RESULTS. The study population comprised 54 males and 5 females, ranging in age from 1 to 68 years old (median age, 21 years). Primary tumors occurred in the mediastinum (n = 27), retroperitoneum (n = 6), central nervous system (CNS; n = 24), and other sites (n = 2). Patients received surgery, chemotherapy, radiotherapy, or a combination of treatment modalities as the primary treatment. Three patients with mediastinal seminoma achieved complete remission (CR) and are alive with no evidence of disease (NED), with a median follow-up of 118 months. Of 24 patients with mediastinal nonseminomas, 8 (33%) are alive with a median disease-free survival (DFS) period of 33 months. Two of six patients with retroperitoneal nonseminomas obtained CR and are alive with NED at 41 and 110 months, respectively. Of 24 patients with intracranial germ cell tumors, 16 had germinoma and 13 (81%) achieved CR with NED at 8-228 months (median duration, 104 months). Four of eight patients with CNS nongerminomas remain in CR and are alive with a median DFS period of 48 months. Four patients with mediastinal nonsemonimas treated with salvage chemotherapy died. CONCLUSIONS. The treatment results of our patients with seminomatous EGCT are comparable to those of Western countries. However, the treatment results of patients with nonseminomatous EGCT are not as good. The reason for this discrepancy needs to be explored for a better treatment outcome of for patients in Taiwan with EGCT.