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1. De Giorgi U, Rosti G, Slavin S, Yaniv I, Harousseau JL, Ladenstein R, Demirer T, Dini G, European Group for Blood and Marrow Transplantation Solid Tumours and Paediatric Disease Working Parties: Salvage high-dose chemotherapy for children with extragonadal germ-cell tumours. Br J Cancer; 2005 Aug 22;93(4):412-7

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Salvage high-dose chemotherapy for children with extragonadal germ-cell tumours.
  • We reviewed the European Group for Blood and Marrow Transplantation (EBMT) experience with salvage high-dose chemotherapy (HDC) in paediatric patients with extragonadal germ-cell tumour (GCT).
  • A total of 23 children with extragonadal GCT, median age 12 years (range 1-20), were treated with salvage HDC with haematopoietic progenitor cell support.
  • The GCT primary location was intracranial site in nine cases, sacrococcyx in eight, retroperitoneum in four, and mediastinum in two.
  • With a median follow-up of 66 months (range 31-173 months), 10 (43%) are continuously disease-free.
  • Of six patients who had a disease recurrence after HDC, one achieved a disease-free status with surgical resection followed by chemotherapy and radiotherapy.
  • Eight of 14 patients (57%) with extracranial primary and three of nine patients (33%) with intracranial primary GCT are currently disease-free.
  • HDC induced impressive long-term remissions as salvage treatment in children with extragonadal extracranial GCTs.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Brain Neoplasms / drug therapy. Child. Child, Preschool. Combined Modality Therapy. Databases, Factual. Disease-Free Survival. Female. Hematopoietic Stem Cell Transplantation. Humans. Infant. Male. Mediastinal Neoplasms / drug therapy. Remission Induction. Retroperitoneal Neoplasms / drug therapy. Retrospective Studies. Salvage Therapy

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  • (PMID = 16106248.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2361583
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2. Ebi H, Nakata M, Tahara M, Igarashi T, Kawada K, Itoh K, Ueda R, Minami H: Extragonadal germ cell tumors in Japan. Cancer Sci; 2003 Dec;94(12):1107-11

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Extragonadal germ cell tumors in Japan.
  • Extragonadal germ cell tumors (EGCT) represent only 2-5% of adult germ cell malignancies.
  • Some publications from Asia have reported inferior treatment outcomes compared to data from an international study group.
  • To ascertain whether this is generally the case, here we analyze treatment outcomes for 30 Japanese patients with EGCT.
  • All patients with seminoma achieved long survival except one who died of chemotherapy-related sepsis.
  • Ten and 11 patients with EGCT presented with mediastinal and retroperitoneal primary sites, respectively.
  • The treatment outcome of Japanese patients with EGCT seemed to be comparable to that reported from international studies, suggesting no difference between ethnic groups.
  • Transient tumor marker elevations on day 7 predict poor survival in EGCT patients and may be a useful parameter for identifying patients requiring more aggressive treatment.
  • [MeSH-major] Biomarkers, Tumor / blood. Neoplasms, Germ Cell and Embryonal / blood. Neoplasms, Germ Cell and Embryonal / mortality
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chorionic Gonadotropin, beta Subunit, Human / blood. Female. Humans. Japan. Male. Middle Aged. Prognosis. Radiotherapy. Retrospective Studies. Survival Analysis. Treatment Outcome. alpha-Fetoproteins / analysis

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  • (PMID = 14662028.001).
  • [ISSN] 1349-7006
  • [Journal-full-title] Cancer science
  • [ISO-abbreviation] Cancer Sci.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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3. Hsu YJ, Pai L, Chen YC, Ho CL, Kao WY, Chao TY: Extragonadal germ cell tumors in Taiwan: an analysis of treatment results of 59 patients. Cancer; 2002 Aug 15;95(4):766-74
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Extragonadal germ cell tumors in Taiwan: an analysis of treatment results of 59 patients.
  • BACKGROUND: Extragonadal germ cell tumors (EGCT) are rare.
  • More investigations are warranted to define the optimal treatment.
  • Primary tumors occurred in the mediastinum (n = 27), retroperitoneum (n = 6), central nervous system (CNS; n = 24), and other sites (n = 2).
  • Patients received surgery, chemotherapy, radiotherapy, or a combination of treatment modalities as the primary treatment.
  • Three patients with mediastinal seminoma achieved complete remission (CR) and are alive with no evidence of disease (NED), with a median follow-up of 118 months.
  • Of 24 patients with mediastinal nonseminomas, 8 (33%) are alive with a median disease-free survival (DFS) period of 33 months.
  • Of 24 patients with intracranial germ cell tumors, 16 had germinoma and 13 (81%) achieved CR with NED at 8-228 months (median duration, 104 months).
  • Four of eight patients with CNS nongerminomas remain in CR and are alive with a median DFS period of 48 months.
  • Four patients with mediastinal nonsemonimas treated with salvage chemotherapy died.
  • CONCLUSIONS: The treatment results of our patients with seminomatous EGCT are comparable to those of Western countries.
  • However, the treatment results of patients with nonseminomatous EGCT are not as good.
  • The reason for this discrepancy needs to be explored for a better treatment outcome of for patients in Taiwan with EGCT.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Mediastinal Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy. Retroperitoneal Neoplasms / therapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Cisplatin / adverse effects. Cisplatin / therapeutic use. Combined Modality Therapy. Female. Germinoma / therapy. Humans. Infant. Male. Middle Aged. Retrospective Studies. Survival Analysis. Taiwan. Treatment Outcome

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  • [Copyright] Copyright 2002 American Cancer Society.DOI 10.1002/cncr.10738
  • (PMID = 12209720.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
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4. Häcker A, Hatzinger M, Knoll T, Michel MS, Köhrmann KU, Alken P, Siegsmund M: [Metachronous testicular tumor of an extragonadal germ cell tumor]. Aktuelle Urol; 2003 Oct;34(6):413-5
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  • [Title] [Metachronous testicular tumor of an extragonadal germ cell tumor].
  • INTRODUCTION: Approximately 5 - 7 % of germ cell tumors are of extragonadal origin.
  • Biology and genetics are unclear, especially when the primary location is in the retroperitoneum.
  • Chemotherapy is the initial treatment of choice for extragonadal germ cell tumors (EGGCTs), followed by surgical resection of the residual tumor mass.
  • A primary testicular tumor must be ruled out by sonographic investigation and biopsy.
  • The rate of metachronous testicular cancer in men with primary EGGCT is largely unknown.
  • CASE REPORT: We present the first patient in the literature who developed a metachronous testicular cancer 10 months after primary occurrence of EGGCT in the retroperitoneum.
  • CONCLUSIONS: This case report emphasizes the importance of follow-up examinations of patients with primary EGGCTs.
  • They should include careful sonographic investigation of the testis in order to detect metachronous testicular cancer early.
  • Intraoperative histopathology can be false-negative for cancer detection, as an immunohistochemical examination is not available.
  • [MeSH-major] Carcinoma in Situ / diagnosis. Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Second Primary / diagnosis. Retroperitoneal Neoplasms / diagnosis. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Diagnostic Imaging. Etoposide / administration & dosage. Humans. Male. Neoadjuvant Therapy. Neoplasm Staging. Orchiectomy. Reoperation. Testis / pathology

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  • (PMID = 14579191.001).
  • [ISSN] 0001-7868
  • [Journal-full-title] Aktuelle Urologie
  • [ISO-abbreviation] Aktuelle Urol
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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5. Geldart TR, Simmonds PD, Mead GM: Orchidectomy after chemotherapy for patients with metastatic testicular germ cell cancer. BJU Int; 2002 Sep;90(4):451-5
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  • [Title] Orchidectomy after chemotherapy for patients with metastatic testicular germ cell cancer.
  • OBJECTIVE: To evaluate the contribution of routine orchidectomy in the management of patients who present with advanced, metastatic, testicular germ cell cancer and who are treated with initial chemotherapy.
  • PATIENTS AND METHODS: Sixty consecutive patients presenting with metastatic testicular germ cell cancer and treated with initial chemotherapy followed by orchidectomy were identified.
  • The pathological findings at orchidectomy were compared with the pathological findings from metastatic masses resected after chemotherapy, and are reviewed with the clinical outcome.
  • RESULTS: Of the 60 orchidectomy specimens after chemotherapy, 24 (40%) contained significant histological abnormalities comprising residual invasive germ cell cancer, intratubular germ cell neoplasia and/or mature teratoma.
  • Six (10%) orchidectomy specimens contained residual invasive germ cell cancer, three nonseminomatous germ cell cancer (NSGCT) and three seminoma.
  • The patients with residual invasive NSGCT present within the testis had evidence of residual invasive NSGCT within extragonadal masses resected after chemotherapy; all three have relapsed and died from chemorefractory progressive disease.
  • CONCLUSION: Orchidectomy after chemotherapy is recommended in all patients undergoing primary chemotherapy, as a significant proportion (40%) are left with histological abnormalities that predispose to subsequent relapse.
  • Persistence of invasive NSGCT at the site of the primary tumour after chemotherapy is associated with persistence of invasive disease at other metastatic sites and is a poor prognostic finding.
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Agents / therapeutic use. Humans. Male. Middle Aged. Prognosis. Seminoma / drug therapy. Seminoma / secondary. Seminoma / surgery


6. Fizazi K, Prow DM, Do KA, Wang X, Finn L, Kim J, Daliani D, Papandreou CN, Tu SM, Millikan RE, Pagliaro LC, Logothetis CJ, Amato RJ: Alternating dose-dense chemotherapy in patients with high volume disseminated non-seminomatous germ cell tumours. Br J Cancer; 2002 May 20;86(10):1555-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Alternating dose-dense chemotherapy in patients with high volume disseminated non-seminomatous germ cell tumours.
  • Only about half of patients with a poor-prognosis non-seminomatous germ-cell tumours can achieve a cure.
  • The aim of this phase II study was to assess the efficacy and toxicity of a dose-dense alternating chemotherapy regimen in this subset of patients.
  • High volume non-seminomatous germ-cell tumours was defined as follows: at least two sites of non pulmonary metastases, an extragonadal primary tumour, a serum human chorionic gonadotropin level higher than 10 000 mIU x ml(-1), or a alpha-foetoprotein level higher than 2000 mIU ml(-1).
  • Patients were retrospectively classified according to the International Germ-Cell Cancer Consensus Group classification; 38 patients (66%) had poor-prognosis disease and 19 patients (33%) had intermediate-prognosis.
  • Forty-two patients (72.4%) had a complete response to therapy.
  • With a median follow-up time of 31 months, the 3-year progression-free survival rate was 71% (95% confidence interval, 60 to 84%) and the 3-year overall survival rate was 73% (95% confidence interval: 62 to 86%).
  • The dose-dense BOP-CISCA-POMB-ACE regimen is highly active in patients with non-seminomatous germ-cell tumours classified as intermediate-prognosis or poor-prognosis according to the International Germ-Cell Cancer Consensus Group.
  • Because outcomes with this regimen compare favourably with outcome after standard therapy, dose-dense chemotherapy should be further investigated in this subset of patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Seminoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Anemia, Refractory, with Excess of Blasts / chemically induced. Biomarkers, Tumor / blood. Bleomycin / administration & dosage. Bleomycin / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Dactinomycin / administration & dosage. Dactinomycin / adverse effects. Disease-Free Survival. Doxorubicin / administration & dosage. Doxorubicin / adverse effects. Etoposide / administration & dosage. Etoposide / adverse effects. Gastrointestinal Diseases / chemically induced. Hematologic Diseases / chemically induced. Humans. Lung Neoplasms / drug therapy. Lung Neoplasms / secondary. Male. Methotrexate / administration & dosage. Methotrexate / adverse effects. Middle Aged. Peripheral Nervous System Diseases / chemically induced. Prognosis. Prospective Studies. Remission Induction. Survival Analysis. Survival Rate. Treatment Outcome. Vincristine / administration & dosage. Vincristine / adverse effects

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  • [Copyright] comCopyright 2002 Cancer Research UK
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  • (PMID = 12085204.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 11056-06-7 / Bleomycin; 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; YL5FZ2Y5U1 / Methotrexate; BOP-CISCA-POMB-ACE regimen
  • [Other-IDs] NLM/ PMC2746595
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7. Young A, Madi A, Treanor D, Millson C, Selby P, Chester J: Fulminant hepatic failure in a patient with advanced extragonadal germ cell tumour. BMJ Case Rep; 2010;2010
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  • [Title] Fulminant hepatic failure in a patient with advanced extragonadal germ cell tumour.
  • Fulminant hepatic failure (FHF) in association with metastatic cancer, without evidence of liver metastases, has not been previously reported in the literature.
  • This report concerns a case of FHF in a 36-year-old man with advanced germ cell tumour arising from an extragonadal (retroperitoneal) primary.
  • Liver function and encephalopathy improved following chemotherapy, suggesting prompt diagnosis and treatment may have cured the patient.
  • Following completion of chemotherapy, he developed spontaneous bacterial endocarditis, requiring aortic valve replacement, a rare complication of curative chemotherapy.
  • At 44 months post completion of chemotherapy, he has regained his premorbid performance status and has returned to work.
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Carboplatin / therapeutic use. Humans. Liver / pathology. Male. Tomography, X-Ray Computed

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  • (PMID = 22778367.001).
  • [ISSN] 1757-790X
  • [Journal-full-title] BMJ case reports
  • [ISO-abbreviation] BMJ Case Rep
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; BG3F62OND5 / Carboplatin
  • [Other-IDs] NLM/ PMC3027936
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8. Hartmann JT, Einhorn L, Nichols CR, Droz JP, Horwich A, Gerl A, Fossa SD, Beyer J, Pont J, Schmoll HJ, Kanz L, Bokemeyer C: Second-line chemotherapy in patients with relapsed extragonadal nonseminomatous germ cell tumors: results of an international multicenter analysis. J Clin Oncol; 2001 Mar 15;19(6):1641-8
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  • [Title] Second-line chemotherapy in patients with relapsed extragonadal nonseminomatous germ cell tumors: results of an international multicenter analysis.
  • PURPOSE: Relapsed extragonadal germ cell tumors patients (EGGCT) are treated with identical salvage chemotherapy regimens, as are patients with metastatic testicular cancer.
  • This investigation evaluates the results of second-line chemotherapy in nonseminomatous EGGCT and tries to identify prognostic factors for survival.
  • All had received cisplatin-containing regimens as induction treatment.
  • RESULTS: Twenty-seven of 142 patients (19%) were long-term disease-free, 11% with primary mediastinal and 30% of patients with primary retroperitoneal disease.
  • Median follow-up since start of salvage treatment was 11 months (range, 1 to 157) for all patients and 45 months (range, 6 to 157) for surviving patients.
  • Forty-eight patients (34%) received high dose chemotherapy with autologous bone marrow transplant at relapse, and 10 of these patients (21%) are continuously disease-free.
  • Primary mediastinal location (P =.003), sensitivity to cisplatin (P =.003), elevated beta-HCG at relapse (P: =.04), and normal LDH at diagnosis (P =.01) were shown to be significant negative prognostic factors for overall survival in univariate; mediastinal location [relative risk ratios (HR) = 1.9; 95% confidence intervals (CI), 1.2 to 3.0] and sensitivity to cisplatin [HR = 2.4; 95% CI, 1.1 to 5.2] were significant negative prognostic factors in multivariate analysis.
  • CONCLUSION: Although current salvage strategies will cure between 20% and 50% of recurrent metastatic testicular cancer, relapsed nonseminomatous EGGCT patients appear to have an inferior survival rate, in particular in case of primary mediastinal location.
  • Mediastinal primary tumor and inadequate response to cisplatin-based induction chemotherapy have been identified as independent negative prognostic factors, both associated with an approximately two-fold higher risk for failure of salvage treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mediastinal Neoplasms / drug therapy. Neoplasms, Germ Cell and Embryonal / drug therapy. Retroperitoneal Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Cisplatin / administration & dosage. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local. Prognosis. Retrospective Studies. Risk Factors. Salvage Therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 11250992.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
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9. Hartmann JT, Nichols CR, Droz JP, Horwich A, Gerl A, Fossa SD, Beyer J, Pont J, Kanz L, Einhorn L, Bokemeyer C: Prognostic variables for response and outcome in patients with extragonadal germ-cell tumors. Ann Oncol; 2002 Jul;13(7):1017-28
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  • [Title] Prognostic variables for response and outcome in patients with extragonadal germ-cell tumors.
  • BACKGROUND: This investigation evaluates prognostic variables in patients with seminomatous and non-seminomatous extragonadal germ-cell tumors (EGCT) in order to identify relevant factors for long-term outcome following cisplatin-based chemotherapy.
  • Uni- and multivariate analyses of prognostic variables for survival and for response to chemotherapy were performed.
  • RESULTS: Data were available for 635 EGCT patients, 104 with seminomatous and 524 with non-seminomatous EGCT (n = 7 not specified).
  • For non-seminomatous EGCT the following independent adverse factors were identified: presence of either liver, lung or central nervous system metastases, primary mediastinal tumor or elevation of pretreatment beta-human gonadotropin; for extragonadal seminoma (only univariate) adverse factors were: presence of liver metastases, two or greater metastatic sites or International Germ Cell Cancer Collaborative Group (IGCCCG) grouping (intermediate versus good).
  • Integration of these variables produced the following prognostic risk groupings: 'excellent prognosis', all seminomatous EGCT (89% 5-year survival rate); 'intermediate low', 'intermediate high' and 'poor', all non-seminomatous EGCT with a 69, 55 and 17% 5-year survival rate, respectively.
  • Classification and regression tree (CART) modeling confirmed histology and location of primary tumor as the major prognosticators.
  • For the subgroup of patients with mediastinal non-seminoma, the 2-year survival rate ranged from 34 to 84%.
  • Multivariate testing for the probability to respond to chemotherapy revealed non-seminomatous histology, primary mediastinal tumor site, and the presence of liver, lung or CNS metastases as independent adverse factors.
  • CONCLUSIONS: In EGCT, prognostic variables for the outcome and for the response to chemotherapy could be identified, which in part differ from gonadal GCT.
  • The proposed model might help to better understand the specific prognosis of EGCT and to tailor risk-adapted treatment strategies.
  • In addition, CART analysis demonstrated the heterogenous prognosis of patients with mediastinal non-seminoma.

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  • (PMID = 12176779.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins
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10. Hartmann JT, Nichols CR, Droz JP, Horwich A, Gerl A, Fossa SD, Beyer J, Pont J, Einhorn L, Kanz L, Bokemeyer C: The relative risk of second nongerminal malignancies in patients with extragonadal germ cell tumors. Cancer; 2000 Jun 1;88(11):2629-35
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  • [Title] The relative risk of second nongerminal malignancies in patients with extragonadal germ cell tumors.
  • BACKGROUND: Apart from a recognized association between extragonadal mediastinal germ cell tumors (GCT) and the occurrence of hematologic malignancies, the risk of developing second nongerminal solid tumors after the diagnosis or treatment of extragonadal GCT is unknown.
  • METHODS: Six hundred thirty-five consecutive patients with extragonadal GCT treated at 11 centers in the U.S. and Europe during the era of cisplatin-based chemotherapy (1975-1996) were included into a large database.
  • RESULTS: No treatment-related leukemia was observed in 611 patients treated with chemotherapy.
  • Four solid tumors (57%) developed in patients with primary mediastinal and 3 tumors (43%) developed in patients with retroperitoneal GCT.
  • Six patients had been treated with chemotherapy and one patient with radiotherapy.
  • Six of 7 solid tumors (86%) had developed within 5 years and 7 of 7 solid tumors within 10 years of diagnosis.
  • The median time period to the occurrence of neoplasia was 47 months (range, 9-145 months).
  • Four cutaneous tumors were observed (melanoma, two patients; basal cell carcinoma, one patient; and squamous cell carcinoma, one patient); the other three tumors were angiosarcoma, nonsmall cell lung carcinoma, and colorectal carcinoma.
  • The overall risk for developing a second tumor was not increased compared with an age-matched general population with a standard incidence ratio (SIR) of 1.49 (95% CI, 0.60-3.06).
  • An elevated risk for skin tumors was observed in all extragonadal GCT patients (SIR, 4.00 [95% CI, 1.
  • 09-10.24]), as well as in the subgroup of patients treated with chemotherapy (SIR, 5.33 [95% CI, 1.45-13.65]).
  • CONCLUSIONS: This analysis excludes an increased biologic risk of developing second solid malignancies in patients with extragonadal GCT except for the previously reported association between primary mediastinal nonseminoma and hematologic disorders.
  • The overall risk of developing second malignancies in extragonadal GCT patients appears to be comparable to that in patients with primary testicular carcinoma.
  • The incremental occurrence of skin malignancies in patients treated with chemotherapy should be investigated further.
  • [MeSH-major] Carcinoma. Germinoma. Neoplasms, Second Primary. Testicular Neoplasms
  • [MeSH-minor] Adolescent. Adult. Aged. Carcinoma, Basal Cell / therapy. Confidence Intervals. Humans. Logistic Models. Male. Melanoma / therapy. Middle Aged. Registries. Risk

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  • [Copyright] Copyright 2000 American Cancer Society.
  • (PMID = 10861442.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] UNITED STATES
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11. Rosti G, De Giorgi U, Wandt H, Lioure B, Leyvraz S, Kolbe K, Papiani G, Ballardini M, Kulekci A, Demirer T, Solid Tumours Working Party: First-line high-dose chemotherapy for patients with poor prognosis extragonadal germ cell tumors: the experience of the European Bone Marrow Transplantation (EBMT) Solid Tumors Working Party. Bone Marrow Transplant; 2004 Dec;34(12):1033-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] First-line high-dose chemotherapy for patients with poor prognosis extragonadal germ cell tumors: the experience of the European Bone Marrow Transplantation (EBMT) Solid Tumors Working Party.
  • Extragonadal germ cell tumors are classified according to the staging system of the International Germ Cell Cancer Collaborative Group (IGCCCG).
  • The 5-year overall and disease-free survival rates for poor prognosis patients are 41 and 48%, respectively after standard-dose chemotherapy.
  • We report the experience of the EBMT Solid Tumours Working Party (STWP) with first-line HDCT with hematopoietic progenitor cell support (HPCS) in patients with poor prognosis extragonadal nonseminomatous germ cell tumor (NSGCT).
  • Between 1990 and 2001, 22 extragonadal NSGCT patients (21 M, 1 F), median age 30 years (range 17-52) were treated with first-line HDCT with HPCS.
  • Primary site was mediastinum in 11 patients, retroperitoneum in 10, and unknown in one.
  • No treatment-related deaths occurred.
  • No patient developed myelodysplasia or a secondary leukemia.
  • The survival rates of patients with poor prognosis extragonadal NSGCT treated with first-line HDCT in the EBMT STWP experience appear higher than that expected according to the IGCCCG classification.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Germinoma / drug therapy
  • [MeSH-minor] Adolescent. Adult. Female. Hematopoietic Stem Cell Transplantation. Humans. Male. Middle Aged. Prognosis. Registries. Remission Induction. Retrospective Studies. Risk Adjustment. Survival Analysis

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  • [Copyright] Bone Marrow Transplantation (2004).
  • (PMID = 15516940.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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12. Bokemeyer C, Hartmann JT, Fossa SD, Droz JP, Schmol HJ, Horwich A, Gerl A, Beyer J, Pont J, Kanz L, Nichols CR, Einhorn L: Extragonadal germ cell tumors: relation to testicular neoplasia and management options. APMIS; 2003 Jan;111(1):49-59; discussion 59-63
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Extragonadal germ cell tumors: relation to testicular neoplasia and management options.
  • An unselected population of 635 consecutive extragonadal GCT patients (EGCT) treated between 1975 through 1996 at 11 cancer centers was retrospectively evaluated for clinical prognosis and biological features of this disease.
  • Five hundred twenty-four patients (83%) had a nonseminomatous GCT, and 104 patients (16%) a seminomatous histology; 341 (54%) patients had a primary mediastinal EGCT, and 283 patients (45%) a retroperitoneal EGCT.
  • Following platinum based induction chemotherapy+/-secondary surgery, 141 patients (49%) with mediastinal nonseminomas (median follow up period: 19 months) and 144 patients (63%) with retroperitoneal nonseminoma (median follow up period: 29 months) are alive [p=0.0006].
  • Multivariate analysis revealed nonseminomatous histology, the presence of non-pulmonary visceral metastases, primary mediastinal GCT location, and elevated beta-HCG as independent prognostic factors for shorter survival.
  • Sixteen patients (4.1%) developed a metachronous testicular cancer despite the use of platinum based chemotherapy.
  • Patients with pure seminomatous EGCT histology have a long term chance of cure of almost 90% irrespective of the primary tumor site.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Germinoma / secondary. Germinoma / therapy. Mediastinal Neoplasms / therapy. Neoplasms, Second Primary / therapy. Retroperitoneal Neoplasms / therapy. Testicular Neoplasms / secondary
  • [MeSH-minor] Adolescent. Adult. Aged. Biomarkers / analysis. Chorionic Gonadotropin, beta Subunit, Human / analysis. Cisplatin / therapeutic use. Drug Therapy, Combination. Hematologic Diseases / pathology. Humans. Male. Middle Aged. Multivariate Analysis. Retrospective Studies. Seminoma / pathology. Seminoma / therapy. Survival Rate

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  • (PMID = 12752235.001).
  • [ISSN] 0903-4641
  • [Journal-full-title] APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
  • [ISO-abbreviation] APMIS
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers; 0 / Chorionic Gonadotropin, beta Subunit, Human; Q20Q21Q62J / Cisplatin
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13. Bokemeyer C, Nichols CR, Droz JP, Schmoll HJ, Horwich A, Gerl A, Fossa SD, Beyer J, Pont J, Kanz L, Einhorn L, Hartmann JT: Extragonadal germ cell tumors of the mediastinum and retroperitoneum: results from an international analysis. J Clin Oncol; 2002 Apr 1;20(7):1864-73
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Extragonadal germ cell tumors of the mediastinum and retroperitoneum: results from an international analysis.
  • PURPOSE: To characterize the clinical and biologic features of extragonadal germ cell tumor (EGCT) and to determine the overall outcome with currently available treatment strategies.
  • PATIENTS AND METHODS: Of an unselected population of 635 consecutive patients treated from 1975 through 1996 at 11 cancer centers, 341 patients (54%) had primary mediastinal EGCT, and 283 patients (45%) had retroperitoneal EGCT.
  • Five hundred twenty-four patients (83%) had a nonseminomatous germ cell tumor (GCT), and 104 patients (16%) had a seminomatous histology.
  • RESULTS: After platinum-based induction chemotherapy with or without secondary surgery, 141 patients (49%) with mediastinal nonseminomas (median follow-up, 19 months; range, 1 to 178 months) and 144 patients (63%) with retroperitoneal nonseminoma (median follow-up, 29 months; range, 1 to 203 months) are alive (P =.0006).
  • In contrast, the overall survival rate for patients with a seminomatous EGCT is 88%, with no difference between patients with mediastinal or retroperitoneal tumor location (median follow-up, 49 months; range, 4 to 193 months; respective 70 months; range, 1 to 211 months).
  • A significantly lower progression-free survival rate was found in seminoma patients treated with initial radiotherapy alone compared with chemotherapy.
  • Nonseminomatous histology, presence of nonpulmonary visceral metastases, primary mediastinal GCT location, and elevated beta-human chorionic gonadotropin were independent prognostic factors for shorter survival.
  • Hematologic malignancies (n = 17) occurred without exception in patients with primary mediastinal nonseminoma.
  • Sixteen patients developed a metachronous testicular cancer despite the use of platinum-based chemotherapy.
  • CONCLUSION: Whereas patients with pure seminomatous EGCT histology have a long-term chance of cure of almost 90% irrespective of the primary tumor site, 45% of patients with mediastinal nonseminomas are alive at 5 years.
  • This outcome is clearly inferior compared with patients with nonseminomatous retroperitoneal primary tumors.
  • [MeSH-major] Germinoma / diagnosis. Germinoma / therapy. Mediastinal Neoplasms / diagnosis. Mediastinal Neoplasms / therapy. Retroperitoneal Neoplasms / diagnosis. Retroperitoneal Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Biomarkers, Tumor / analysis. Chemotherapy, Adjuvant. Diagnosis, Differential. Europe. Female. Humans. Male. Medical Records. Middle Aged. Multivariate Analysis. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Risk Factors. Salvage Therapy. Seminoma / diagnosis. Seminoma / therapy. Survival Analysis. Treatment Outcome. United States

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  • (PMID = 11919246.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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14. Feldman DR, Sheinfeld J, Bajorin DF, Fischer P, Turkula S, Ishill N, Patil S, Bains M, Bosl GJ, Motzer RJ: Paclitaxel (T) plus ifosfamide (I) followed by high-dose carboplatin (C) and etoposide (E) with autologous stem cell support for patients (pts) with previously treated germ cell tumors (GCT): TI-CE results and prognostic factor analysis in 107 pts. J Clin Oncol; 2009 May 20;27(15_suppl):5027

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Paclitaxel (T) plus ifosfamide (I) followed by high-dose carboplatin (C) and etoposide (E) with autologous stem cell support for patients (pts) with previously treated germ cell tumors (GCT): TI-CE results and prognostic factor analysis in 107 pts.
  • : 5027 Background: Pts with incomplete response (IR) to first-line chemotherapy or relapsed primary mediastinal non-seminomatous GCT (NSGCT) have <10% 3-year (yr) survival with conventional-dose salvage regimens (Cancer. 67:1305).
  • METHODS: Phase I/II trial of TI-CE conducted in GCT pts with progressive disease following chemotherapy and unfavorable prognostic features (extragonadal primary site, IR to first-line therapy, or relapse/IR to ifosfamide/cisplatin-based conventional-dose salvage).
  • RESULTS: Of 107 pts, primary site was testis in 72, mediastinum (all NSGCT) in 21, and other in 14.
  • 81 had 1 prior line of therapy and 26 had ≥2.
  • 5-yr disease-free survival (DFS) was 47% and overall survival 52% with a median follow-up of 61 months (m).
  • 5/21 (24%) primary mediastinal NSGCT and 2/7 late relapses are continuously disease-free.
  • On multivariate analysis, primary mediastinal site (p = 0.0002), ≥2 lines of prior therapy (p = 0.0005), baseline HCG >1000 (p = 0.01), and lung metastases (p = 0.02) significantly predicted adverse DFS.
  • CONCLUSIONS: TI-CE is effective salvage therapy for GCT pts with poor prognostic features.
  • Mediastinal primary site and ≥2 lines of prior therapy were most predictive of adverse DFS.

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  • (PMID = 27962915.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Mardiak J, Rejlekova K, Mego M, Rajec J, Sycova-Mila Z, Obertova J, Salek T, Reckova M: Determination of efficacy of TIP combination (paclitaxel, ifosfamide, cisplatin) as first salvage therapy for patients with relapsed germ cell tumors in a poor prognosis group. J Clin Oncol; 2009 May 20;27(15_suppl):e16049

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Determination of efficacy of TIP combination (paclitaxel, ifosfamide, cisplatin) as first salvage therapy for patients with relapsed germ cell tumors in a poor prognosis group.
  • : e16049 Background: The efficacy of TIP appears to be suitable salvage therapy for patients with relapsed germ cell tumors (GCTs) with good prognostic features.The aim of our study was to determine the efficacy of TIP as first salvage therapy for patients with relapsed GCTs with poor prognostic features.
  • METHODS: Thirty seven patients with relapsed GCTs were treated with TIP as first salvage therapy.
  • Sixteen (43%) patients had favorable prognostic features for response (testis primary tumor site and prior complete response to induction chemotherapy regimen) and 21 (57%) patients had poor prognostic features (either extragonadal site or incomplete response to induction chemotherapy regimen).
  • 9 (43%) of 21 patients with poor prognosis achieved a favorable response to chemotherapy, from whom only 1 (10%) patient achieved CR, but 5 patients achieved durable response at a median follow-up duration of 60,6 months.
  • CONCLUSIONS: Demonstrated long-term survival of patients with poor prognosis in our nonrandomised study with limited number of patients refers to the TIP being suitable therapy also for patients with relapsed GCTs with poor prognosis.
  • These results warrant the need to continue investigation of real effectiveness of TIP as a first salvage therapy even for patients with poor prognostic features.

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  • (PMID = 27963009.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Berkmen F, Peker AF, Ayyildiz A, Başay S, Arik AI, Uğur I: Extragonadal germ cell tumors: clinicopathologic findings, staging and treatment experience in 14 patients. J Exp Clin Cancer Res; 2000 Sep;19(3):281-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Extragonadal germ cell tumors: clinicopathologic findings, staging and treatment experience in 14 patients.
  • Extragonadal germ cell tumors (EGCT) are a rare group of neoplasms histologically identical to testicular counterparts.
  • Fourteen cases of primary mediastinal and retroperitoneal germ cell tumors were treated with chemotherapy and radiotherapy between 1987 and 1999 in Ankara Oncology Hospital.
  • The neccesity of a uniform staging system and treatment programs are discussed.
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chorionic Gonadotropin, beta Subunit, Human / blood. Combined Modality Therapy. Disease-Free Survival. Humans. Liver Neoplasms / secondary. Male. Middle Aged. Neoplasm Staging. Remission Induction. alpha-Fetoproteins / metabolism

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  • (PMID = 11144519.001).
  • [ISSN] 0392-9078
  • [Journal-full-title] Journal of experimental & clinical cancer research : CR
  • [ISO-abbreviation] J. Exp. Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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17. Rejlekova K, Mego M, Rajec J, Sycova-Mila Z, Obertova J, Mardiak J: A rare case of malignant extragonadal germ cell tumor in the pineal region with an aggressive behaviour. Bratisl Lek Listy; 2009;110(5):296-7
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  • [Title] A rare case of malignant extragonadal germ cell tumor in the pineal region with an aggressive behaviour.
  • Though germ cell cancer is rare, it is the most common cancer in males between 20 and 40 years.
  • The primary site for the development of germ cell tumor is testes, but it can be seen in extragonadal locations as well.
  • Herein, we present a rare case of a 19-year-old patient with non/seminomatous extragonadal germ cell tumor in the pineal region with an aggressive behaviour, refractory to the combined therapy (surgery, radio- and chemotherapy).
  • We suggest that early diagnosis and aggressive multimodal approaches along with surgery, radiotherapy and chemotherapy is necessary to improve the outcome of these patients (Ref. 5).
  • [MeSH-major] Brain Neoplasms. Neoplasms, Germ Cell and Embryonal. Pineal Gland

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  • (PMID = 19507665.001).
  • [ISSN] 0006-9248
  • [Journal-full-title] Bratislavské lekárske listy
  • [ISO-abbreviation] Bratisl Lek Listy
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Slovakia
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18. Bokemeyer C, Droz JP, Horwich A, Gerl A, Fossa SD, Beyer J, Pont J, Schmoll HJ, Kanz L, Einhorn L, Nichols CR, Hartmann JT: Extragonadal seminoma: an international multicenter analysis of prognostic factors and long term treatment outcome. Cancer; 2001 Apr 1;91(7):1394-401
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Extragonadal seminoma: an international multicenter analysis of prognostic factors and long term treatment outcome.
  • BACKGROUND: The objectives of this study were to evaluate the long term outcome of patients with extragonadal seminomatous germ cell tumors (GCT) so that prognostic variables for disease recurrence and patient survival could be identified and to access the efficacy of different treatment modalities.
  • METHODS: Six hundred thirty-five patients with extragonadal GCT who were treated consecutively at 11 centers in the United States and Europe during the cisplatin-based chemotherapy era between 1975 and 1996 were evaluated retrospectively.
  • RESULTS: Fifty-two patients with primary retroperitoneal GCT (50%) and 51 patients with primary mediastinal GCT (49%) of pure seminomatous histology were identified (n = 1 patient with a primary cervical lymph node) representing 16.4% of 635 patients with extragonadal GCT who were included in the data base.
  • Treatment consisted of platin-based chemotherapy in 77 patients (74%), radiotherapy in 9 patients (9%), and combined modality in 18 patients (17%).
  • Ninety-two percent of patients (95% confidence interval, 87-97%) achieved a favorable response to primary therapy.
  • After a median follow-up of 61 months (range, 1-211 months), 18 patients (17%) have had recurrent disease: 14% of those who received chemotherapy and 67% of those who received radiation therapy.
  • The 5-year progression free survival rate favored the chemotherapy group, with 87% compared with 33% for irradiated patients (P = 0.006), whereas the overall survival rates were equal (90% vs. 67%; P = 0.13).
  • No differences in overall survival or progression free survival were observed among patients with primary retroperitoneal and mediastinal seminoma.
  • CONCLUSIONS: In patients with extragonadal seminoma, a survival rate of > 90% at 5 years is achieved with adequate cisplatin-based chemotherapy.
  • Compared with patients with nonseminomatous extragonadal GCT, no difference in long term survival exists between patients with primary retroperitoneal or mediastinal seminoma location.
  • Primary radiotherapy seems to be associated with a significantly higher rate of disease recurrence, although most patients will be salvaged by subsequent chemotherapy.
  • [MeSH-major] Mediastinal Neoplasms / therapy. Retroperitoneal Neoplasms / therapy. Seminoma / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Agents / therapeutic use. Biomarkers, Tumor / analysis. Cisplatin / therapeutic use. Combined Modality Therapy. Follow-Up Studies. Humans. Middle Aged. Prognosis. Survival Rate. Treatment Outcome

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  • [Copyright] Copyright 2001 American Cancer Society.
  • (PMID = 11283942.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; Q20Q21Q62J / Cisplatin
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19. Feldman DR, Sheinfeld J, Bajorin DF, Fischer P, Turkula S, Ishill N, Patil S, Bains M, Reich LM, Bosl GJ, Motzer RJ: TI-CE high-dose chemotherapy for patients with previously treated germ cell tumors: results and prognostic factor analysis. J Clin Oncol; 2010 Apr 01;28(10):1706-13
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  • [Title] TI-CE high-dose chemotherapy for patients with previously treated germ cell tumors: results and prognostic factor analysis.
  • PURPOSE: We previously reported a dose-finding and phase II trial of the TI-CE regimen (paclitaxel [T] plus ifosfamide [I] followed by high-dose carboplatin [C] plus etoposide [E] with stem-cell support) in germ cell tumor (GCT) patients predicted to have a poor prognosis with conventional-dose salvage therapy.
  • PATIENTS AND METHODS: Eligible patients had advanced GCTs with progressive disease following chemotherapy and unfavorable prognostic features (extragonadal primary site, incomplete response [IR] to first-line therapy, or relapse/IR to ifosfamide-cisplatin-based conventional-dose salvage).
  • RESULTS: Most patients were platinum refractory and had an IR to first-line chemotherapy.
  • Five (24%) of 21 primary mediastinal nonseminomatous GCTs are continuously disease free.
  • On MVA, primary mediastinal site (P < .001), two or more lines of prior therapy (P < .001), baseline human chorionic gonadotropin > or = 1,000 U/L (P = .01), and lung metastases (P = .02) significantly predicted adverse DFS.
  • CONCLUSION: TI-CE is effective salvage therapy for GCT patients with poor prognostic features.
  • Mediastinal primary site and two or more lines of prior therapy were most predictive of adverse DFS.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Adult. Carboplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Etoposide / administration & dosage. Female. Hematopoietic Stem Cell Transplantation. Humans. Ifosfamide / administration & dosage. Male. Middle Aged. Paclitaxel / administration & dosage. Prognosis. Retreatment. Salvage Therapy

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  • [Cites] Eur J Cancer. 1998 Nov;34(12):1883-8 [10023310.001]
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  • (PMID = 20194867.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; UM20QQM95Y / Ifosfamide
  • [Other-IDs] NLM/ PMC3651604
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20. Kuroda I, Ueno M, Mitsuhashi T, Nakagawa K, Yanaihara H, Tsukamoto T, Deguchi N: Testicular seminoma after the complete remission of extragonadal yolk sac tumor : a case report. BMC Urol; 2004 Nov 16;4:13
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  • [Title] Testicular seminoma after the complete remission of extragonadal yolk sac tumor : a case report.
  • BACKGROUND: Between 2% and 5% of malignant germ-cell tumors in men arise at extragonadal sites.
  • Of extragonadal germ cell tumors, testicular carcinoma in situ (CIS) are present in 31-42% of cases, and CIS are reported to have low sensitivity to chemotherapy in spite of the various morphology and to have a high likelihood of developing into testicular tumors.
  • A testicular biopsy may thus be highly advisable when evaluating an extragonadal germ cell tumor.
  • CASE PRESENTATION: A 36-year-old man was diagnosed as having an extragonadal non-seminomatous germ cell tumor, that was treated by cisplatin-based chemotherapy, leading to a complete remission.
  • CONCLUSIONS: We herein report a case of metachronous occurrence of an extragonadal and gonadal germ cell tumor.
  • In the evaluation of an extragonadal germ cell tumor, a histological examination should be included since ultrasonography is not sufficient to detect CIS or minute lesions of the testis.
  • [MeSH-major] Endodermal Sinus Tumor / drug therapy. Neoplasms, Second Primary / etiology. Seminoma / etiology. Testicular Neoplasms / drug therapy. Testicular Neoplasms / etiology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Etoposide / administration & dosage. Humans. Male. Orchiectomy. Remission Induction

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  • (PMID = 15546481.001).
  • [ISSN] 1471-2490
  • [Journal-full-title] BMC urology
  • [ISO-abbreviation] BMC Urol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC535804
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21. Deville JL, Gravis G, Salem N, Savoie PH, Esterni B, Walz J, Thomas P, Goncalves A, Viens P, Bladou F: Resection of residual masses after chemotherapy for advanced non-seminomatous germ cell tumours, a monocentric analysis of pre-operative prognosticators. Eur J Cancer Care (Engl); 2010 Nov;19(6):827-32
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  • [Title] Resection of residual masses after chemotherapy for advanced non-seminomatous germ cell tumours, a monocentric analysis of pre-operative prognosticators.
  • Removal of residual masses after chemotherapy in non-seminomatous germ cell tumours (NSGCTs) remains the standard of care.
  • Fifty-one patients underwent surgery after chemotherapy for NSGCT.
  • Histology of residual masses revealed fibrosis in 25 (49%), mature teratoma in 18 (35%) and viable germ cells in 8 (16%).
  • In multivariate analysis, poor prognosis group according to International Germ Cell Cancer Collaborative Group was associated with worse outcome compared with good and intermediate prognosis groups (hazard ratio for events = 26.4; 95% confidence interval 2.46-283.9; P = 0.006) and primary testicular NSGCT was associated with better event-free survival than extragonadal NSGCTs (hazard ratio for events = 0.04; 95% confidence interval 0.004-0.48; P = 0.01).
  • Resection of residual masses after chemotherapy in NSGCT results in favourable long-term survival in most patients.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Agents / therapeutic use. Disease-Free Survival. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Multivariate Analysis. Neoplasm, Residual. Outcome Assessment (Health Care). Prognosis. Proportional Hazards Models. Retrospective Studies. Risk Factors. Young Adult

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  • [Copyright] © 2009 The Authors. European Journal of Cancer Care © 2009 Blackwell Publishing Ltd.
  • (PMID = 19708949.001).
  • [ISSN] 1365-2354
  • [Journal-full-title] European journal of cancer care
  • [ISO-abbreviation] Eur J Cancer Care (Engl)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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22. Motzer RJ: Paclitaxel (Taxol) combination therapy for resistant germ cell tumors. Semin Oncol; 2000 Feb;27(1 Suppl 1):33-5
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  • [Title] Paclitaxel (Taxol) combination therapy for resistant germ cell tumors.
  • Rob Paclitaxel (Taxol; Bristol-Myers Squibb Company Princeton, NJ) showed antitumor activity in patients with germ cell tumors resistant to combination cisplatin-containing chemotherapy and was included in two risk-directed first-line combination salvage programs.
  • Patients with relapsed germ cell tumors originating from a testis primary site were treated in a phase I/II trial with conventional-dose paclitaxel, ifosfamide, and cisplatin.
  • Fifteen of 21 evaluable patients (71%) achieved a complete or partial response with normal serum tumor markers; 12 patients (57%) remain progression free with a median follow-up period of 15 months.
  • In a second trial, patient with cisplatin-resistant germ cell tumors and unfavorable prognostic features (prior incomplete response or an extragonadal primary site) were treated with a dose-intensive program consisting of rapid recycling of paclitaxel plus ifosfamide followed by carboplatin plus etoposide with stem cell support.
  • Twenty-one of 37 assessable patients (57%) achieved a complete response and two (5%) achieved a partial response with negative serum tumor markers; 15 (41%) of these patients remain in durable response with a median follow-up period of 30 months.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Paclitaxel / administration & dosage. Salvage Therapy
  • [MeSH-minor] Clinical Trials as Topic. Humans. Male. Remission Induction. Testicular Neoplasms / drug therapy. Testicular Neoplasms / pathology

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  • (PMID = 10697042.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] P88XT4IS4D / Paclitaxel
  • [Number-of-references] 15
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23. Billmire D, Vinocur C, Rescorla F, Colombani P, Cushing B, Hawkins E, London WB, Giller R, Lauer S: Malignant mediastinal germ cell tumors: an intergroup study. J Pediatr Surg; 2001 Jan;36(1):18-24
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  • [Title] Malignant mediastinal germ cell tumors: an intergroup study.
  • PURPOSE: This review was conducted to determine clinical characteristics and response to therapy in this rare pediatric neoplasm.
  • METHODS: An intergroup Pediatric Oncology Group (POG) 9049/Children's Cancer Study Group (CCG) 8882 randomized trial was conducted to evaluate response rate and survival with chemotherapy using etoposide, bleomycin, and high or standard dose cisplatin for high-risk malignant germ cell tumors at extragonadal sites.
  • For this review, a secondary analysis of clinical and operative findings in patients with primary site in the mediastinum was carried out.
  • RESULTS: Of the 38 children with malignant mediastinal germ cell tumors (MGCT), 36 had sufficient data to be included in this review.
  • Four patients had biopsy and chemotherapy without tumor resection, and only 1 survived.
  • Fourteen patients had resection at diagnosis followed by chemotherapy with 12 survivors.
  • Eighteen patients had biopsy followed by chemotherapy and postchemotherapy tumor resection with 13 survivors.
  • Tumor size in response to chemotherapy for these 18 patients was stable or increased in 6, and decreased in 12 (mean decrease of 57% in greatest dimension).
  • Overall, 26 of 36 patients survived, with a 4-year patient survival rate of 71%+/-10%, and a 4-year event-free survival rate of 69%+/-10%.
  • Lesions often have incomplete regression with chemotherapy alone.
  • Tumor resection may be undertaken at diagnosis or after attempted shrinkage with chemotherapy.
  • Aggressive attempt at complete tumor resection should be offered to all patients even if bulky tumor persists after induction chemotherapy with expectation of a significant salvage rate.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mediastinal Neoplasms / drug therapy. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Biopsy. Bleomycin / administration & dosage. Child. Child, Preschool. Cisplatin / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Humans. Infant, Newborn. Male. Survival Rate. Treatment Outcome

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  • (PMID = 11150432.001).
  • [ISSN] 0022-3468
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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24. Koshida K, Kato H, Mizokami A, Morishita H, Seto C, Komatsu K, Kou E, Uchibayashi T, Shiobara S, Namiki M: High-dose chemotherapy with peripheral blood stem cell transplantation for advanced testicular cancer. Int J Urol; 2002 Mar;9(3):146-53
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  • [Title] High-dose chemotherapy with peripheral blood stem cell transplantation for advanced testicular cancer.
  • BACKGROUND: The aim of this study was to investigate the efficacy and safety of high-dose chemotherapy (HDCT) for the treatment of patients with advanced testicular cancer.
  • METHODS: Fourteen patients were treated with high-dose carboplatin, etoposide and cyclophosphamide (with or without THP-adriamycin) followed by peripheral blood stem cell transplantation.
  • The treatment was used for two refractory cases, a second relapse, and for consolidation after the first relapse in one case each.
  • It was also used for nine cases as part of the first-line treatment following primary conventional-dose chemotherapy, and for one case as the first salvage for a late recurrent tumor of teratoma with malignant transformation.
  • RESULTS: The first two patients who received intensive pretreatment with cisplatin-based chemotherapy did not respond to HDCT.
  • The two patients who were treated with HDCT as the first or second salvage therapy achieved successful outcomes.
  • The results for the subsequent nine patients (consisting of two with stage IIIC, five with IIIB2, one with IIB, and one extragonadal seminoma) were two progressive disease, three no change and four partial remission.
  • CONCLUSIONS: The results demonstrated the limited efficacy of HDCT even in cases with a good to intermediate risk rating according to classification by the International Germ Cell Cancer Collaborative Group.
  • Because treatment for relapse after HDCT is extremely difficult, new HDCT regimens consisting of drugs that are not used in induction chemotherapy need to be established.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hematopoietic Stem Cell Transplantation. Testicular Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Carboplatin / administration & dosage. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Dose-Response Relationship, Drug. Doxorubicin / administration & dosage. Doxorubicin / analogs & derivatives. Etoposide / administration & dosage. Humans. Male. Middle Aged. Teratoma / drug therapy. Teratoma / therapy

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  • (PMID = 12010324.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; D58G680W0G / pirarubicin; Q20Q21Q62J / Cisplatin; BEP protocol; CEC protocol
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25. Giannis M, Aristotelis B, Vassiliki K, Ioannis A, Konstantinos S, Nikolaos A, Georgios P, Georgios P, Pantelis P, Meletios-Athanasios D: Cisplatin-based chemotherapy for advanced seminoma: report of 52 cases treated in two institutions. J Cancer Res Clin Oncol; 2009 Nov;135(11):1495-500
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  • [Title] Cisplatin-based chemotherapy for advanced seminoma: report of 52 cases treated in two institutions.
  • INTRODUCTION: We evaluated an intensified therapeutic strategy in order to optimize treatment outcomes while maintaining acceptable toxicity in patients with advanced seminoma.
  • Patients with low-risk advanced seminoma, according to the International Germ Cell Cancer Collaborative Group Consensus Classification criteria, had received four cycles of the BEP regimen either in the 5-day or the alternative 3-day schedule, while patients with intermediate-risk advanced seminoma had received four cycles of the IBEP regimen.
  • RESULTS: Forty-two patients (80.7%) had testicular seminoma while ten patients (19.3%) presented with primary extragonadal (mediastinal or retroperitoneal) tumor.
  • Treatment-related toxicity was moderate, with febrile neutropenia being the most prevalent (13.5%).
  • Twenty patients (38.5%) achieved a complete response to chemotherapy.
  • After 69 months of follow-up there were three recurrences that were successfully treated with high-dose or salvage chemotherapy.
  • CONCLUSIONS: Intensified cisplatin-based chemotherapy for patients with advanced seminoma does not confer evidence of superiority over radiotherapy alone or the standard BEP regimen.
  • Patients with low-volume abdominal disease (clinical stage IIA and IIB) can be cured by four cycles of BEP instead of radiotherapy at the cost of a substantial increase in chemotherapy exposure and the resulting toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Seminoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Bleomycin / therapeutic use. Etoposide / therapeutic use. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Retrospective Studies

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  • (PMID = 19437039.001).
  • [ISSN] 1432-1335
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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26. Oldenburg J, Fosså SD: Late relapse of nonseminomatous germ cell tumours. BJU Int; 2009 Nov;104(9 Pt B):1413-7
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  • [Title] Late relapse of nonseminomatous germ cell tumours.
  • Late relapses of nonseminomatous cell tumours (NSGCTs) are rare and occur by definition at > or =2 years after successful treatment.
  • They represent a major challenge of current treatment and follow-up of the affected patients.
  • We present relevant literature on late-relapsing NSGCTs to provide an overview over the effect of primary treatment, patient and tumour characteristics.
  • Of all patients with NSGCT, 1-6% have a late relapse, with those having extragonadal GCTs being at greatest risk.
  • Suboptimal primary treatment, especially insufficient retroperitoneal surgery, increases the risk of late relapses.
  • Radical surgery is probably the most important treatment, with advances in salvage chemotherapy adding to the improved cure rates.
  • Treatment at an experienced institution ensures a 5-year cancer-specific survival of >50%, and this approaches 100% in case of single-site mature teratoma.
  • Diagnosis and proper treatment of patients with late-relapsing NSGCTs is challenging and should be restricted to experienced centres only.
  • [MeSH-major] Neoplasm Recurrence, Local / diagnosis. Neoplasms, Germ Cell and Embryonal / therapy. Retroperitoneal Neoplasms / secondary. Testicular Neoplasms / therapy
  • [MeSH-minor] Early Detection of Cancer. Humans. Lymph Node Excision / methods. Lymphatic Metastasis. Male. Survival Analysis. Teratoma / pathology. Teratoma / secondary. Treatment Outcome

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  • (PMID = 19840022.001).
  • [ISSN] 1464-410X
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 32
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27. Sato S, Tanaka T, Takahashi A, Sasai M, Kitamura H, Masumori N, Tsukamoto T: Late recurrence and second primary malignancy among 139 patients with germ cell tumors: long-term outcome of the disease in a single-center experience. Jpn J Clin Oncol; 2010 Feb;40(2):157-62
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  • [Title] Late recurrence and second primary malignancy among 139 patients with germ cell tumors: long-term outcome of the disease in a single-center experience.
  • OBJECTIVE: We retrospectively evaluated long-term oncological outcomes in patients with germ cell tumors (GCTs) primarily treated at our institution and assessed late recurrence and second primary malignancies.
  • METHODS: This study included a total of 139 males with newly diagnosed GCTs of the testis or extragonadal origin who received treatment, including surgery, chemotherapy and radiation therapy, at our hospital between 1980 and 2005.
  • RESULTS: In patients with seminoma, 5-year progression-free survival and cause-specific survival rates were 87.2% and 100% for Stage I, 88.9% and 100% for Stage II, and 50.0% and 50.0% for Stage III, respectively, whereas in those with non-seminomatous GCTs, they were 79.1% and 96.3% for Stage I, 89.5% and 89.4% for Stage II, and 85.7% and 78.4% for Stage III, respectively.
  • Late recurrence was found in five (3.6%) patients and all of them responded to salvage treatment and achieved disease-free status.
  • Second primary hematological neoplasms occurred in three (2.2%), although they had a long-term free of the primary disease.
  • All died of the second primary disease.
  • CONCLUSIONS: Late recurrence was successfully managed with appropriate treatments, although its incidence was not negligible.
  • Periodic follow-up may be necessary for >5 years in patients with GCTs for early detection of late recurrence.
  • In addition, care should be taken to watch for the development of life-threatening second primary malignant disease during long-term follow-up.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / pathology. Neoplasms, Second Primary / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Disease-Free Survival. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies. Seminoma / pathology. Seminoma / therapy. Time Factors

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  • (PMID = 19906660.001).
  • [ISSN] 1465-3621
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2813544
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28. Fakhr IM, Khalil el-SA, El-Baradie TS, Shaalan MA, Shalaby LM, Nassif SL, Farahat IG: The role of surgical management in pediatric germ cell tumors (GCTs), NCI case series. J Egypt Natl Canc Inst; 2008 Mar;20(1):70-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of surgical management in pediatric germ cell tumors (GCTs), NCI case series.
  • PURPOSE: To review the experience of a tertiary referral center in pediatric germ cell tumors (GCTs) in the last 8 years and to investigate the impact of surgery and site of disease on prognosis.
  • PATIENTS AND METHODS: We retrospectively analyzed the cases of pediatric germ cell tumors at National Cancer Institute over an 8 years period.
  • A total of 34 children with (GCTS) were found, with a mean age, at presentation, of 6.7 years and a follow-up period ranging from 3-52 months.
  • Anatomic distribution of GCTs according to sex organ involvement was either gonadal in 21 patients (61.8%) or extragonadal in 13 patients (38.2%).
  • Adjuvant chemotherapy was administered in 28 out of 33 patients (84.8%), following surgery, including all patients with extragonadal disease.
  • Pelvic extragonadal site was the worst site regarding resectability.
  • Complete surgical resection showed better disease free survival, while those with irresectable disease had comparable overall survival while none could be rendered disease free with chemotherapy.
  • CONCLUSION: The initial surgical approach to malignant GCTs at all sites should be complete resection when possible; the morbidity of extensive surgical resection should be weighed carefully against the good tumor control with chemotherapy.
  • The site of primary disease plays a role in the prognosis of pediatric germ cell tumors with the extragonadal pelvic tumors being the worst regarding resectability.
  • Good tumor response can be achieved with surgery and chemotherapy even for advanced stage and metastatic disease.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / surgery
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Female. Humans. Infant. Lymphatic Metastasis. Male. Neoplasm Staging. Prognosis. Retrospective Studies

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  • (PMID = 19847284.001).
  • [ISSN] 1110-0362
  • [Journal-full-title] Journal of the Egyptian National Cancer Institute
  • [ISO-abbreviation] J Egypt Natl Canc Inst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
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29. Archie PH, Beasley MB, Ross HJ: Biphasic pulmonary blastoma with germ cell differentiation in a 36-year-old man. J Thorac Oncol; 2008 Oct;3(10):1185-7
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  • [Title] Biphasic pulmonary blastoma with germ cell differentiation in a 36-year-old man.
  • We describe the clinical and pathologic findings of a young man with a heterogeneous mediastinal tumor metastatic to both lungs, and containing a predominant pattern of classic biphasic pulmonary blastoma with elements of immature teratoma, seminoma, and embryonal carcinoma.
  • Surgery is the primary treatment, but prognosis is poor and chemotherapy and radiation have been used for unresectable disease.
  • A discussion of pulmonary blastoma and extragonadal germ cell tumors is presented.
  • [MeSH-major] Lung Neoplasms / pathology. Mediastinal Neoplasms / pathology. Neoplasms, Germ Cell and Embryonal / pathology. Neoplasms, Multiple Primary / pathology. Pulmonary Blastoma / pathology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Marrow Transplantation. Cell Differentiation. Chorionic Gonadotropin, beta Subunit, Human / analysis. Combined Modality Therapy. Humans. Male. alpha-Fetoproteins / analysis

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  • (PMID = 18827617.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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30. Fabre E, Jira H, Izard V, Ferlicot S, Hammoudi Y, Theodore C, Di Palma M, Benoit G, Droupy S: 'Burned-out' primary testicular cancer. BJU Int; 2004 Jul;94(1):74-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] 'Burned-out' primary testicular cancer.
  • OBJECTIVE: To report the natural history of 'burned-out' testicular tumour (a testicular tumour that has regressed spontaneously with no treatment and that generally presents at the stage of metastases).
  • Patients explored for extragonadal germ cell tumour present with various clinical features depending on the site of the metastases.
  • CONCLUSION: Despite the controversial hypotheses of the origin of these tumours, extragonadal germ cell tumours should be considered to be metastases of a 'burned-out' primary testicular tumour that must be investigated.
  • When a primary testicular tumour is detected, the testis must be removed, and standard chemotherapy yields good long-term results.
  • The hypothesis of an immunological reaction against the tumour inducing the spontaneous necrosis of the primary tumour and possibly the metastases should be considered.
  • [MeSH-major] Neoplasm Regression, Spontaneous. Neoplasms, Germ Cell and Embryonal / pathology. Neoplasms, Unknown Primary / pathology. Testicular Neoplasms / pathology. Testis / pathology
  • [MeSH-minor] Adolescent. Adult. Biopsy / methods. Humans. Male. Middle Aged. Retroperitoneal Neoplasms / pathology. Retroperitoneal Neoplasms / radiography. Tomography, X-Ray Computed

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  • (PMID = 15217435.001).
  • [ISSN] 1464-4096
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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31. Sun XF, Yang QY, Zhen ZJ, Xia Y, Huang ZH, Ling JY: [Treatment outcome of children and adolescents with germ cell tumor after combined therapy---a report of 44 cases]. Ai Zheng; 2006 Dec;25(12):1529-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Treatment outcome of children and adolescents with germ cell tumor after combined therapy---a report of 44 cases].
  • BACKGROUND & OBJECTIVE: The overall survival rate of children and adolescents with germ cell tumor is more than 75% after adopting combined therapy.
  • However, the prognosis varies with stage, pathologic type, and primary tumor site.
  • This study was to analyze the clinical characteristics and treatment outcome of children and adolescents with germ cell tumor, and to investigate the prognostic factors and therapeutic strategy.
  • METHODS: Clinical characteristics, treatment outcome, and prognostic factors of 44 children and adolescents with germ cell tumor, treated in Cancer Center of Sun Yat-sen University from Jan.
  • RESULTS: Of the 44 patients, 25 received adjuvant chemotherapy after operation; 1 received operation alone; 18 received induction chemotherapy.
  • Of the 18 patients, 7 received tumor resection after chemotherapy; 2 patients with primary mediastinal chorioepithelioma with multiple metastases received radiotherapy on residual disease after chemotherapy; 1 patient with postoperative abdominal metastasis and 1 with postoperative lung metastasis achieved complete remission after chemotherapy; 1 patient with mediastinal sinus tumor achieved partial remission after chemotherapy; 6 had poor response to chemotherapy and died of disease progression.
  • Chemotherapy-treated patients received platinum-containing regimens for 2-7 cycles.
  • For previously untreated patients, the 3-year survival rate was 96.0% for gonadal germ cell tumor patients and 61.0% for extragonadal germ cell tumor patients.
  • CONCLUSION: Surgery combined with platinum-containing chemotherapy can improve efficacy and survival of children and adolescents with germ cell tumor.
  • For the patients with stage IV, relapsed, and metastatic tumors, novel therapeutic regimens with increased dose intensity need further investigation.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / surgery
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Chemotherapy, Adjuvant. Child. Child, Preschool. Cisplatin / therapeutic use. Endodermal Sinus Tumor / drug therapy. Endodermal Sinus Tumor / pathology. Endodermal Sinus Tumor / surgery. Etoposide / therapeutic use. Female. Follow-Up Studies. Humans. Infant. Male. Mediastinal Neoplasms / drug therapy. Mediastinal Neoplasms / pathology. Mediastinal Neoplasms / surgery. Neoplasm Recurrence, Local. Neoplasm Staging. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / pathology. Ovarian Neoplasms / surgery. Remission Induction. Survival Rate. Teratoma / drug therapy. Teratoma / pathology. Teratoma / surgery. Testicular Neoplasms / drug therapy. Testicular Neoplasms / pathology. Testicular Neoplasms / surgery. Treatment Outcome. Vincristine / therapeutic use

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  • (PMID = 17166380.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol; COB protocol
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32. Gilligan TD, Seidenfeld J, Basch EM, Einhorn LH, Fancher T, Smith DC, Stephenson AJ, Vaughn DJ, Cosby R, Hayes DF, American Society of Clinical Oncology: American Society of Clinical Oncology Clinical Practice Guideline on uses of serum tumor markers in adult males with germ cell tumors. J Clin Oncol; 2010 Jul 10;28(20):3388-404
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] American Society of Clinical Oncology Clinical Practice Guideline on uses of serum tumor markers in adult males with germ cell tumors.
  • PURPOSE: To provide recommendations on appropriate uses for serum markers of germ cell tumors (GCTs).
  • Primary outcomes included marker accuracy to predict the impact of decisions on outcomes.
  • An expert panel developed consensus guidelines based on data from 82 reports.
  • Lacking data on primary outcomes, most Panel recommendations are based on secondary outcomes (relapse rates and time to relapse).
  • RECOMMENDATIONS: The Panel recommended against using markers to screen for GCTs, to decide whether orchiectomy is indicated, or to select treatment for patients with cancer of unknown primary.
  • To stage patients with testicular nonseminomas, the Panel recommended measuring three markers (alpha-fetoprotein [AFP], human chorionic gonadotropin [hCG], and lactate dehydrogenase [LDH]) before and after orchiectomy and before chemotherapy for those with extragonadal nonseminomas.
  • They also recommended measuring AFP and hCG shortly before retroperitoneal lymph node dissection and at the start of each chemotherapy cycle for nonseminoma, and periodically to monitor for relapse.
  • They recommended against using markers to guide or monitor treatment for seminoma or to detect relapse in those treated for stage I.
  • [MeSH-major] Biomarkers, Tumor / blood. Neoplasms, Germ Cell and Embryonal / blood
  • [MeSH-minor] Adult. Decision Making. Humans. Male. Mediastinal Neoplasms / blood. Neoplasms, Unknown Primary / blood. Orchiectomy. Retroperitoneal Neoplasms / blood. Seminoma / blood. Testicular Neoplasms / blood

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  • (PMID = 20530278.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Practice Guideline
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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33. Popadiuk S, Korzon M, Chybicka A, Szmyd K, Balwierz W, Trelinska J, Kowalczyk J, Wisniewska-Slusarz H, Woźniak W, Bilska K, Wachowiak J, Wysocki M, Krawczuk-Rybak M, Szumera M, Sznurkowska K, Renke J: [Analysis of risk factor treatment failures in therapeutic programme for malignant germ cell tumours in children. Multicentre prospective study of Polish Pediatric Group for Solid Tumours 1998--2006]. Med Wieku Rozwoj; 2007 Jul-Sep;11(3 Pt 2):301-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Analysis of risk factor treatment failures in therapeutic programme for malignant germ cell tumours in children. Multicentre prospective study of Polish Pediatric Group for Solid Tumours 1998--2006].
  • AIMS: The aim of the study was the analysis of risk factors of therapeutic failures in children with malignant germ cell tumours treated within the multicentre programme of PPGGL from 1999--2006.
  • MATERIALS AND METHODS: The investigated group included 18 (14.3%) patients, of 123 who have finished the treatment of malignant germ cell tumour, in whom no remission was obtained or relapse occurred.
  • RESULTS: Among 18 patients with therapeutic failures 12 died.
  • Two patients from the high risk group died of complications of the treatment--sepsis during neutropenia after chemotherapy and one after haemorrhage to the central nervous system.
  • 10 (82%) of 12 patients who died had extragonadal location and in 11 (92%) the tumour was in stage III or IV of the disease.
  • The most frequent histology in this group was mixed germ cell tumour with component of yolk sac tumour or carcinoma embrionale.
  • In 11 (92%) patients primary chemoresistance was observed, and radical surgery was not possible for the reason of advanced stage of the disease.
  • In 3 patients testis was the primary location (I and II stage), in 3 patients the tumour was localized in the sacrococcygeal region (III and IV stage).
  • All the patients are alive in remission after second line therapy, with 78 months (median) of follow-up.
  • The main risk factor for therapeutic failures in malignant germ cell tumours was primary chemoresistance in inoperable tumours of the sacrococcygeal region.
  • 2. The mortality of treatment complications was low.
  • 3. The relapse of cancer was not a risk factor for therapeutic failure due to the high probability of second remission 4.
  • Therapeutic failures are mainly observed in patients with mixed germ cell tumour with components of yolk sac tumour or carcinoma embrionale.
  • [MeSH-major] Neoplasm Recurrence, Local. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Drug Resistance, Neoplasm. Female. Humans. Infant. Male. Poland. Risk Factors. Treatment Failure

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  • (PMID = 18663271.001).
  • [Journal-full-title] Medycyna wieku rozwojowego
  • [ISO-abbreviation] Med Wieku Rozwoj
  • [Language] pol
  • [Publication-type] Clinical Trial; English Abstract; Journal Article; Multicenter Study
  • [Publication-country] Poland
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34. Bakhshi S, Singh D, Karak AK, Thulkar S: Childhood primary mesenteric seminoma. Indian J Pediatr; 2006 Mar;73(3):241-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Childhood primary mesenteric seminoma.
  • We report an 11-year-old child who presented with an abdominal lump and was diagnosed as having an extragonal primary mesenteric seminoma.
  • Patient was treated with 4 cycles of combination chemotherapy cisplatin, etoposide and bleomycin; he is now disease free for 2 years.
  • We discuss and review extragonadal germ cell tumors arising from the mesentery and their management.
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Child. Cisplatin / therapeutic use. Etoposide / therapeutic use. Humans. Male

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  • (PMID = 16567922.001).
  • [ISSN] 0973-7693
  • [Journal-full-title] Indian journal of pediatrics
  • [ISO-abbreviation] Indian J Pediatr
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] India
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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35. Marina N, Chang KW, Malogolowkin M, London WB, Frazier AL, Womer RB, Rescorla F, Billmire DF, Davis MM, Perlman EJ, Giller R, Lauer SJ, Olson TA, Children's Oncology Group: Amifostine does not protect against the ototoxicity of high-dose cisplatin combined with etoposide and bleomycin in pediatric germ-cell tumors: a Children's Oncology Group study. Cancer; 2005 Aug 15;104(4):841-7
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  • [Title] Amifostine does not protect against the ototoxicity of high-dose cisplatin combined with etoposide and bleomycin in pediatric germ-cell tumors: a Children's Oncology Group study.
  • BACKGROUND: High-dose cisplatin combined with etoposide and bleomycin (HDPEB) improves event-free survival (EFS) in advanced pediatric germ-cell tumors (PGCT), but has significant ototoxicity.
  • METHODS: Eligibility criteria included age < 15 years and unresectable Stage III/IV extracranial, extragonadal PGCT.
  • Primary sites included sacrococcygeal area/pelvis (n = 15), vagina (n = 5), and other (n = 5).
  • [MeSH-major] Amifostine / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Hearing Disorders / prevention & control. Neoplasms, Germ Cell and Embryonal / drug therapy. Radiation-Protective Agents / administration & dosage


36. Armstrong AC, Blackhall FH: Management of cancer from an unknown primary. Expert Opin Pharmacother; 2007 Mar;8(4):445-55
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of cancer from an unknown primary.
  • Treatment of cancer is reliant on identifying the organ of origin.
  • However, in a significant minority of cases, the primary site is never identified.
  • This paper reviews the diagnostic work-up and therapeutic management for patients presenting with unknown primary cancer, including the role of tumour markers, conventional pathology and positron emission tomography imaging.
  • It is important to identify atypical presentations of known tumour types, such as extragonadal germ cell tumours, lymphomas and breast cancer.
  • The results from chemotherapy trials performed in patients with unknown primary cancer are summarised.
  • Few trials have included > 100 patients, and most are non-randomised.
  • There is no clear standard of care from the available data, and no trials of chemotherapy versus best supportive care have been performed.
  • Platinum is the mainstay of treatment regimens, and from the regimens tested, a taxane seems to be among the best of the cytotoxics to combine with platinum in terms of both tolerability and efficacy.
  • There is no data to favour a three-drug combination over a two-drug combination.
  • To improve on existing treatment, molecular techniques may provide a means to identify the organ of origin, and/or to select appropriate targeted therapies.
  • Further research is needed to improve knowledge on the biology of cancer from an unknown primary and to develop more effective treatment.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Neoplasms, Unknown Primary / therapy

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  • (PMID = 17309339.001).
  • [ISSN] 1744-7666
  • [Journal-full-title] Expert opinion on pharmacotherapy
  • [ISO-abbreviation] Expert Opin Pharmacother
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 92
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37. Miller KD, Michael H, Jacobson L, Sutton GP: Primary yolk sac tumor of the rectum. Cancer Invest; 2000;18(7):597-601
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary yolk sac tumor of the rectum.
  • Extragonadal germ cell tumors are well recognized in men but have rarely been reported in women.
  • Reports have primarily focused on the pediatric population and have suggested a poor prognosis for extragonadal yolk sac tumors.
  • A 23-year-old woman with a yolk sac tumor arising in the rectum is described.
  • A review of the English-language literature (MEDLINE 1966-1998) regarding extragonadal germ cell tumors in females is provided.
  • Treatment with four courses of cisplatin, etoposide, and bleomycin was followed by surgical resection of the involved area.
  • Previous reports are limited by the small number of patients, focus on the pediatric population, and treatment before the availability of cisplatin.
  • Extragonadal germ cell tumors in women are extremely rare but can be successfully treated with aggressive chemotherapy and surgery similar to testis cancer.
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Female. Humans

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  • (PMID = 11036466.001).
  • [ISSN] 0735-7907
  • [Journal-full-title] Cancer investigation
  • [ISO-abbreviation] Cancer Invest.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
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38. Kim E, Bae TS, Kwon Y, Kim TH, Chung KW, Kim SW, Ro J, Lee ES: Primary malignant teratoma with a primitive neuroectodermal tumor component in thyroid gland: a case report. J Korean Med Sci; 2007 Jun;22(3):568-71
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  • [Title] Primary malignant teratoma with a primitive neuroectodermal tumor component in thyroid gland: a case report.
  • Teratomas comprise the most common extragonadal germ cell tumors in childhood.
  • We report a case of a 31-yr-old female with a huge neck mass.
  • Pathologic examination revealed it to be malignant teratoma composed of primitive neuroepithelial tissue with primitive neural tubes and loose myxoid to fibrous immature mesenchymal stroma.
  • The patient underwent extensive evaluation of the thyroid gland with computed tomography (CT) scan and positron emission tomography (PET) scan, which revealed no evidence of metastatic disease.
  • She underwent total thyroidectomy with bilateral modified radical neck dissection, intensive chemotherapy and radiotherapy.
  • This is the first case, to our knowledge, of malignant thyroid teratoma with a exuberant primitive neuroectodermal tumor component in Korea.
  • [MeSH-minor] Adult. Female. Head and Neck Neoplasms / pathology. Humans. Neoplasm Metastasis. Positron-Emission Tomography / methods. Thyroid Diseases / diagnosis. Thyroidectomy. Tomography, X-Ray Computed

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  • (PMID = 17596674.001).
  • [ISSN] 1011-8934
  • [Journal-full-title] Journal of Korean medical science
  • [ISO-abbreviation] J. Korean Med. Sci.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2693658
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39. Mickisch GH: Prognostic parameters for the management of advanced testis tumours. Curr Opin Urol; 2000 Sep;10(5):465-71
MedlinePlus Health Information. consumer health - Testicular Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The need for prognostic parameters in testicular germ cell tumours is sometimes questioned based on an overall cure rate of more than 80% of the patients regardless of tumour stage.
  • However, the trend for an earlier and more accurate diagnosis amenable to curative treatment as well as the high effectiveness of standard Cisplatinum containing chemotherapy has masked the continuing need for intensifying therapy in patients with adverse risk factors.
  • This intense treatment is often associated with worrysome morbidity and the assessment of prognostic factors, stage by stage, is warranted on which patient at risk can be identified and treated accordingly.
  • Traditional prognostic factors, on which most classification systems are based, include large tumour volume, the presence of liver, bone or brain metastasis, grossly elevated tumour markers and an extragonadal primary site, particularly in the mediastinum.
  • Clearly, the infrastructure and the experience of the treating uro-oncology unit (see 1) is decisive for treatment outcomes, and -at least-'difficult to treat' patients should be referred to properly resourced cancer centres.
  • However, the search for even better (molecular) biologic factors is speeding up because more complex treatment decisions such as in advanced testicular cancers rely on a more precise determination of prognosis, enabling a more tailored selection of individualized therapeutic options.
  • [MeSH-major] Biomarkers, Tumor / analysis. Neoplasms, Germ Cell and Embryonal / pathology. Testicular Neoplasms / pathology

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  • (PMID = 11005453.001).
  • [ISSN] 0963-0643
  • [Journal-full-title] Current opinion in urology
  • [ISO-abbreviation] Curr Opin Urol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 23
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40. Mola Arizo MJ, Gonzalvo Pérez V, Torregrosa Maicas MD, Navarro Antón JA, Gómez-Ferrer Lozano A, Estany Pérez A, Polo Peris AC: [Burn out bilateral testicular tumor]. Actas Urol Esp; 2005 Mar;29(3):318-21
MedlinePlus Health Information. consumer health - Testicular Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Differentiating a primary retroperitoneal seminoma from a metastatic testicular tumor with an occult testicular primary or a burned out testicular cancer remains difficult.
  • The patient received chemotherapy and underwent surgery of the residual retroperitoneal mass and bilateral orchiectomy.
  • All surgical specimens were negative for testis cancer.
  • CONCLUSION: Primary extragonadal germ cell tumors in the retroperitoneum are a rare entity.
  • The presence of a retroperitoneal tumor with ultrasonographical abnormalities in testicular evaluation should be considered as a metastases of a burned out testicular cancer, and biopsy is mandatory.
  • [MeSH-major] Neoplasms, Multiple Primary. Retroperitoneal Neoplasms. Seminoma. Testicular Neoplasms

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  • (PMID = 15945261.001).
  • [ISSN] 0210-4806
  • [Journal-full-title] Actas urologicas espanolas
  • [ISO-abbreviation] Actas Urol Esp
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
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41. Dieckmann KP, Classen J, Souchon R, Loy V: [Management of testicular intraepithelial neoplasia (TIN)--a review based on the principles of evidence-based medicine]. Wien Klin Wochenschr; 2001 Jan 15;113(1-2):7-14
MedlinePlus Health Information. consumer health - Testicular Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Transliterated title] Therapie der testikulären intraepithelialen Neoplasie (TIN)--eine Ubersicht auf Grundlage der evidenzbasierten Medizin (EBM).
  • Testicular intraepithelial neoplasia (TIN; also called carcinoma in situ of the testis) is the uniform precursor of testicular germ cell tumors.
  • There is general agreement on the biological significance of TIN, however, the treatment is still a matter of dispute.
  • The present review summarizes the treatment options currently available.
  • Therefore, fertility aspects should be considered before any kind of treatment is employed.
  • Nonetheless, individual patients may qualify for sperm banking or cryopreservation of testicular tissue for future sperm extraction (TESE) and assisted fertilization.
  • The most common clinical situation is the case of contralateral TIN in the presence of unilateral testicular cancer.
  • Low dose radiotherapy to the testis with 18 Gy is the standard management option in these patients.
  • The same procedure may be applied to solitary testicles after partial orchiectomy for germ cell tumors.
  • If chemotherapy is required due to metastatic disease of the primary tumor management of TIN should be deferred.
  • After chemotherapy 30% of TIN cases will persist and approximately 42% will recur in the later course.
  • Repeat biopsy should be done six months after completion of chemotherapy or later.
  • If one testicle is afflicted with TIN while the other testis is in healthy condition (conceivable in infertility cases or patients with primary extragonadal germ cell tumors), then the TIN-bearing testis should be excised.
  • [MeSH-major] Carcinoma / diagnosis. Carcinoma / therapy. Orchiectomy / adverse effects. Testicular Neoplasms / diagnosis. Testicular Neoplasms / therapy. Testis / pathology

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  • (PMID = 11233474.001).
  • [ISSN] 0043-5325
  • [Journal-full-title] Wiener klinische Wochenschrift
  • [ISO-abbreviation] Wien. Klin. Wochenschr.
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Austria
  • [Number-of-references] 67
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