ISSN:
1437-7772
Keywords:
extragonadal germ-cell tumor
;
mediastinal germ-cell tumor
;
retroperitoneal germ-cell tumor
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background We treated nine patients with uncommon and high-risk extragonadal germ-cell tumors (EGCTs) between 1982 and 1991. Methods Anterior mediastinal lesions were located in five patients, retroperitoneal tumors in three patients, and in one patient both mediastinal and retroperitoneal tumors were found. Chemotherapeutic regimens consisted of cisplatin, vincristine, bleomycin and actinomycin D (PVcBA); cisplatin, vinblastine and bleomycin (PVB); vinblastine, actinomycin D, cyclophosphamide, bleomycin and cisplatin (VAB-6); and bleomycin, etoposide and two doses of cisplatin (high-dose BEP). Results Two patients receiving PVcBA and second-line chemotherapy showed partial responses. Six patients; one treated with PVB, two with VAB-6, and three others with high-dose BEP with or without additional chemotherapy, underwent surgical resection of residual tumors. Histologic examinations showed either necrotic debris or necrosis including mature teratoma (complete response). In one patient, whose tumor marker was negative, unresectable residual tumors continued to shrink and disappeared with no maintenance therapy following administration of high-dose BEP. Overall, 7 of 9 patients (77.8%) achieved a complete response to either chemotherapy alone or a combination of chemotherapy and surgery. One patient, who suffered a relapse from an apparent CR, was also treated successfully. These patients remain disease free. Conclusion Patients with EGCTs are curable, even if the tumors in question are in highly advanced stages, as long as appropriate chemotherapy and surgical resection are undertaken in a timely fashion.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF02347269
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