- 作者：Kenji Hashimoto ; M.D.a ; Hiroyuki Fujimoto ; M.D.c ; Tsutomu Kouno ; M.D.a ; tkouno@ncc.go.jp ; Masahiro Koseki ; M.D. ; M.Sc.b ; Kan Yonemori ; M.D.a ; Taizo Hirata ; M.D.a ; Mayu Yunokawa ; M.D.a ; Chikako Shimizu ; M.D.a ; Noriyuki Katsumata ; M.D.a ; Kenji Tamura ; M.D. ; Ph.D.a ; Masashi Ando ; M.D.a ; Masahiro Takeuchi ; M.D. ; M.P.H.b ; Hiroyuki Nakanishi ; M.D.c ; Motokiyo Komiyama ; M.D.c ; Tohru Nakagawa ; M.D. ; Ph.D.c ; Yasuhiro Fujiwara ; M.D. ; Ph.D.a
- 关键词：Metachronous testicular germ cell tumor ; Extragonadal germ cell tumor ; Outcome ; Management ; Testicular biopsy
- 刊名：Urologic Oncology: Seminars and Original Investigations
- 出版年：2012
- 出版时间：May-June, 2012
- 年：2012
- 卷：30
- 期：3
- 页码：319-324
- 全文大小：468 K
Objectives
The optimal management of extragonadal germ cell tumor (EGGCT) and metachronous testicular germ cell tumor (MTGCT) has not been determined.Patients and methods
Fifty-one consecutive patients with EGGCT were identified. Testicular palpation or ultrasonography to rule out a primary testicular tumor was performed. Pretreatment testicular biopsies were not performed. The incidence and outcome of MTGCT, and the prognosis of EGGCT were evaluated.
Results
Twenty-five and 26 patients, respectively, had mediastinal and retroperitoneal EGGCT. Fourteen and 37 patients, respectively, had seminoma and nonseminoma. Five patients developed MTGCT in patients with retroperitoneal EGGCT. The median interval from the primary treatment for EGGCT to MTGCT diagnosis was 64 months (range 15-120). The cumulative risk of developing MTGCT was 8.3 % at 6 y. Five patients underwent an orchiectomy and have survived in the 16-months median follow-up period (range 4-30). Among the patients with seminomatous and nonseminomatous EGGCT, the 5-year survival rate was 84.6 % and 78.3 % , respectively. Among the patients with retroperitoneal and mediastinal nonseminomatous EGGCT, the 5-year survival rate was 94.7 % and 58.8 % , respectively.
Conclusions
The prognosis of EGGCT without testicular biopsies was sufficient. EGGCT patients, especially retroperitoneal EGGCT, need long-term follow-up for MTGCT.