Surgical techniques and outcomes for primary nonseminomatous germ cell tumors

Patients with primary mediastinal nonseminomatous germ cell tumors are usually young men with large anterior mediastinal masses. The diagnosis can usually be established with measurement of serum tumor markers and a fine-needle aspiration biopsy. The mainstay of treatment is cisplatin-based chemotherapy. Resection of the residual postchemotherapy mass is usually necessary and is performed even with persistently elevated tumor markers if a clean resection is possible. The finding of necrotic tumor predicts long-term survival, whereas persistent germ cell cancer has a less favorable prognosis.