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Long-term survival and prognostic factors in extragonadal germ cell tumors: a 30-year experience at a single
Patricia Capdevila1, Cristobal Carrasco2, Elisa Gómez2
1Department of Medical Oncology, Hospital Universitario y Politécnico La Fe, Avda. Abril Martorell 106, 46016, Valencia, Spain. pacapgau@alumni.uv.es.
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.
