Retrospective clinico-pathological study of germ cell tumours managed in a single institution

Abstract

Objective: To study the clinico-pathological characteristics and outcome of germ cell tumours treated in the Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong. Methods: This was a single-institution retrospective review of patients with extrancranial, non-ovarian germ cell tumours treated in the department from 1995 to 2004. Clinico-pathological characteristics and outcome were analysed. Overall, cause-specific, and event-free survivals were evaluated by the Kaplan-Meier method and compared using the log rank test. Results: In all, 110 male patients were followed up for a median of 8 years. Their median age was 33 (range, 17-79) years. Ninety-eight (89%) of the patients had a testicular primary, and 12 (11%) had mediastinal primaries. Seventy-two (65%) were seminomas, and 38 (35%) were non-seminomas. The mean 5-year overall survivals for patients with stage I, 11, and 111 testicular tumour were 100%, 92%, and 81%, respectively. The mean 5-year overall survival for patients with mediastinal primaries was 75%. For stage I seminoma, 29 (62%) of the patients were managed by chemotherapy, 11 (23%) by radiotherapy, 2 (4%) by sequential chemotherapy and radiotherapy, and 5 (11%) by surveillance; all of whom survived 5 years. For advanced germ cell tumours, the respective mean 5-year overall survivals were 90%, 100%, and 36% for patients classified as having a good, intermediate, and poor prognosis (according to the International Germ Cell Cancer Collaborative Group prognostic grouping). Conclusion: Patients having early-stage germ cell tumours have an excellent prognosis with a high cure rate. The outcome of patients having an International Germ Cell Cancer Collaborative Group classified as poor, remains unfavourable. Overall, the treatment outcome in our cohort was comparable to the global experience. © 2010 Hong Kong College of Radiologists.