Year: 2026
Type: article
Study design: Observational Study
Abstract: AIM: To describe the treatment pattern and outcomes for patients with extracranial, extragonadal germ cell tumors (EGCTs). METHODS: We conducted a retrospective analysis of male patients with EGCT prospectively registered in the Australian GCT clinical registry (iTestis) since its inception in 2018. Demographics, clinicopathologic features, treatment characteristics, and outcomes were recorded. Data were analyzed using descriptive statistics and the Kaplan-Meier method estimates of overall survival (OS). RESULTS: Of 1256 patients in the iTestis registry, 33 (3%) had EGCT including 18 (55%) with mediastinal, 14 (42%) with retroperitoneal, and 1 (3%) with a lung primary. The median age was 31 years (range: 24-38), ECOG performance status was 0-1 in 26 (79%), and 21 (64%) were non-seminoma. Chemotherapy was administered upfront in 27 (82%) patients, upfront surgery in four patients (12%), and treatment was unknown in two (6%) patients. The most common chemotherapy regimen was bleomycin/etoposide/cisplatin (BEP) (n = 20, 74%), followed by etoposide/ifosfamide/cisplatin (VIP) (n = 5, 19%) and EP (n = 2, 7%). Post-chemotherapy surgery was carried out in 16 (59%) patients, and 4 (15%) patients received second-line chemotherapy. At a median follow-up of 22.7 months (range: 0-126), no deaths were observed in individuals with retroperitoneal primary (n = 14), seminoma (n = 12), or International Germ Cell Cancer Collaborative Group (IGCCCG) good (n = 15) and intermediate risk (n = 3) disease. Three deaths occurred in patients with mediastinal non-seminoma. The estimated 24-month OS for mediastinal non-seminoma and IGCCCG poor risk disease was 71% (95% confidence interval [CI]: 27%-94%) and 79% (95% CI: 25%-95%), respectively. CONCLUSION: Incidence of EGCT in Australia is consistent with published literature. Treatment patterns reflect international practices. Primary mediastinal non-seminoma has the poorest outcomes. Primary retroperitoneal and primary mediastinal seminomas have excellent outcomes.
DOI: 10.1111/ajco.70083
Authors: Kar Ven Cavan Chow, Ciara Conduit, Sophie O'Haire, Anna Kuchel, Shirley Wong, Peter Grimison, Andrew Weickhardt, Ganes Pranavan, James Lynam, Patricia Bastick, Jeffrey Goh, Shomik Sengupta, Annabel Smith, Elizabeth Liow, David Campbell, Ming Wong, Kristina Zlatic, Peter Gibbs, Ben Tran, Chun Loo Gan
Institutions: The University of Queensland, Royal Brisbane and Women's Hospital, The University of Melbourne, Walter and Eliza Hall Institute of Medical Research, Peter MacCallum Cancer Centre, Royal Hobart Hospital, Western Health, Chris O’Brien Lifehouse, Olivia Newton-John Cancer Wellness & Research Centre, Canberra Hospital, Calvary Mater Newcastle Hospital, Eastern Health, Monash University, Monash Health, Barwon Health, St Vincent's Hospital Melbourne
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,700
OpenAlex ID: W7126110656