Comparison of the clinical features and hematopoietic stem cell transplantation outcomes of mediastinal malignant germ cell tumors with nonmediastinal extragonadal placements
| Autor: | Sukru Ozaydin, Deniz Dogan, Birol Yildiz, Nuri Karadurmus, Mustafa Öztürk, Hayati Bilgiç, Fikret Arpaci, Ramazan Öcal, Nesrin Öcal |
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| Rok vydání: | 2016 |
| Předmět: |
extragonadal germ cell tumor
Oncology medicine.medical_specialty medicine.medical_treatment Hematopoietic stem cell transplantation survival OncoTargets and Therapy Internal medicine medicine Pharmacology (medical) Yolk sac Original Research Tumor marker Chemotherapy βhCG business.industry Mediastinum medicine.disease mediastinum α-fetoprotein medicine.anatomical_structure Extragonadal Germ Cell Tumor hematopoietic stem cell transplantation tumor marker Radiology Germ cell tumors Differential diagnosis business |
| Zdroj: | OncoTargets and therapy |
| ISSN: | 1178-6930 |
| DOI: | 10.2147/ott.s107899 |
| Popis: | Nesrin Ocal,1 Birol Yildiz,2 Nuri Karadurmus,2 Deniz Dogan,1 Sukru Ozaydin,2 Ramazan Ocal,3 Mustafa Ozturk,2 Fikret Arpaci,4 Hayati Bilgic1 1Department of Chest Diseases, 2Department of Oncology, Gulhane Military Medical Faculty, Ankara, Turkey; 3Department of Hematology, Medical Faculty, Gazi University, Ankara, Turkey; 4Department of Oncology, Liv Hospital, Ankara, Turkey Objective: Even though the primary mediastinal extragonadal germ cell tumors (EGCTs) are rare, they are noteworthy in the differential diagnosis of mediastinal masses. In this study, we aimed to identify the clinical features of mediastinal malignant GCTs and compare the results of hematopoietic stem cell transplantation between mediastinal and nonmediastinal malignant EGCTs.Method: Data of the patients with EGCT who were treated and underwent hematopoietic stem cell transplantation at our hospital between 1988 and 2015 were retrieved retrospectively. Results were compared between mediastinal and nonmediastinal EGCTs.Results: Data of 65 patients diagnosed with EGCT (37 [56.92%] cases with mediastinal EGCT and 28 [43.07%] cases with nonmediastinal EGCT) were assessed. The clinical stages, frequency of pretransplant status, mean pretransplant time, and mean number of chemotherapy lines before hematopoietic stem cell transplantation were not significantly different between groups. Although the overall survival did not significantly differ between groups, the 5-year survival was significantly higher in mediastinal EGCTs (P=0.02). Yolk sac tumor was significantly more common in mediastinal EGCTs (P=0.05). Mortality rates were higher in seminomas and yolk sac tumors in all cases, higher in embryonal carcinomas in mediastinal EGCT group and higher in yolk sac tumors in nonmediastinal EGCT group. While choriocarcinomas had more aggressive courses in mediastinal EGCTs, seminomas and yolk sac tumors had poorer prognosis in nonmediastinal EGCTs. Short pretransplant time and persistence of elevated posttransplant βhCG and AFP levels were the significant mortality risk factors both in mediastinal and nonmediastinal EGCTs.Conclusion: Mediastinal placement of EGCT was not a poor prognostic factor; furthermore, the 5-year survival was significantly higher in mediastinal EGCTs. According to our knowledge, this is the first study that compares the clinical outcomes of hematopoietic stem cell transplantation of mediastinal and nonmediastinal malignant EGCTs. Keywords: mediastinum, extragonadal germ cell tumor, hematopoietic stem cell transplantation, survival, tumor marker, βhCG, α-fetoprotein |
| Databáze: | OpenAIRE |
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