Retrospective Clinico-pathological Study of Germ Cell Tumours Managed in a Single Institution

Full Article

AKC Leung, KH Au, HY Yiu, YL Kwok, VC Sin, WL Leung, KC Ngan

Hong Kong J Radiol 2010;13:12-22

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, II, and III 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.

 

中文摘要

單一機構治療生殖細胞腫瘤的臨牀病理回顧分析

梁國璋、區國雄、姚浩然、郭婉琳、冼偉松、梁偉濂、顏繼昌

目的:研究香港伊利沙伯醫院臨床腫瘤科診治的生殖細胞腫瘤的臨牀病理特徵及預後。

方法:是項單一機構回顧性分析的研究對象為1995年至2004年間,於上述部門接受治療的顱外非卵 巢生殖細胞腫瘤患者。對臨床病理特徵和治療效果進行分析,以Kaplan-Meier方法評估整體存活率、 特定病因存活率和無併發症存活率,用log rank test比較上述三種存活率。

結果:研究共110名男性患者,隨訪中位數為8年;病人年齡中位數為33歲(介乎17-79歲)。98名 (89%)患者為原發睪丸癌,12名(11%)為原發縱隔腫瘤。72名(65%)患有精原細胞瘤,其餘38 名(35%)則患有非精原細胞瘤。第一、二、三期睪丸癌的平均5年整體存活率分別為100%、92% 和81%;原發縱隔腫瘤患者則為75%。在第一期精原細胞瘤患者中,29名(62%)進行化療、11名(23%)採用放射治療、2名(4%)則使用連續化療和放射治療,而其餘5名(11%)只進行觀察; 全部均可存活5年。根據國際生殖細胞腫瘤合作小組的分類標準,在末期生殖細胞腫瘤患者中,被界 定為「預後良好」、「預後中等」和「預後惡劣」的,其平均5年整體存活率分別為90%、100%和 36%。

結論:早期生殖細胞腫瘤患者有良好預後,治癒率也較高;但根據上述疾病分類標準屬「預後惡 劣」的患者,其治療效果仍不甚理想。總括而言,這項研究的治療結果與全球治療經驗相若。