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J. Nieckula
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-028 - Mediastinal Primary Malignant Germ Cell Tumor - Analysis of Prognostic Factors for Patients' Survival. Single Institution Experience (ID 1360)
09:30 - 09:30 | Author(s): J. Nieckula
- Abstract
Background:
Primary mediastinal malignant germ cell tumours (MGCT) are a rare entity as typical localization of MGCT are gonads. As there is no concept of how to encode diagnosis of primary mediastinal MGCT (PMMGCT), they are usually reported as mediastinal tumor. The primary aim of the study was to evaluate the prognostic factors for survival of patients with PMMGCT.
Methods:
We analyzed data from patients’ medical records who had been diagnosed with a mediastinal tumor and encoded as C38 according to ICD-10. All of them had been diagnosed, treated and followed up in Cancer Center and Institute of Oncology in Gliwice Poland (COI). Patients’ medical records were analysed according to the national low regulation. We found 509 patients (pts) with mediastinal tumor diagnosis and reported as C38 according to ICD-10. The most frequently diagnosed tumors were mesothelioma - 32% of pts, and thymoma - 11% of pts. PMMGCT accounted for approximately 4% (19pts). 47% of them had seminoma and 53% non-seminoma diagnosed (the most frequent was tumor mixed). Median age was 28 years (range 19-41). Only 2 pts did not have any disease symptoms and the mediastinal mass has been discovered accidentally during periodic testing. The most frequent symptoms of disease were mediastinal pain and cough, in 79 and 74% of pts, respectively. The impact of the clinicopathological features was analyzed using the chi-squared test with Yates’ correction. Survival evaluation was performed using the Kaplan Meier estimate with log rank test.
Results:
Median tumor size was 15cm (range 6,5-20cm). All of pts received cisplatin based chemotherapy. In 53% of pts surgery was the primary treatment and the remaining pts started therapy with chemotherapy. 53% of pts experienced mediastinal radiotherapy. Total median dose was 40Gy (range 12-59,5Gy). All pts with seminoma achieved partial or complete response, disease progression was observed only in pts with non-seminoma tumors. 47% of pts had disease recurrence, including only one pts with seminoma. One pts had two high-dose chemotherapies followed by bone marrow transplant. 53% of the pts died due to disease progression or treatment complication, including one pts with seminoma. Median overall survival was 27,5 months with 5-OS of 53%. Pts with seminoma had smaller tumor size than pts with non-seminoma tumors, p=0.03. Pts with a smallers tumor lived longer, p=0.09, however, neither surgery nor radiotherapy had an impact on survival, p=0.5 and 0.2, respectively. Pts with no general disease symptoms lived significantly longer than those who had any disease symptoms, p=0.03. Pts with mediastinal pain at the time at diagnosis lived significantly shorter, p=0.02. Pts with seminoma lived significantly longer than pts with non-seminoma tumors, p<0.001.
Conclusion:
Primary mediastinal germ cell tumours occur mostly in males. Pts with mediastinal MGCT had poor prognosis, nonetheless. Pts with seminoma lived significantly longer than pts with non-seminoma tumors, p<0.001. Tumor size and general disease symptoms were the most important prognostic factors. The results of this study have many limitations, mostly due to the group of pts being small. That is why the results should be taken into consideration with caution.
