Clinical Features and Treatment Outcomes in Patients with Extracranial Germ Cell Tumors: A Tertiary Centre Experience

Abstract

Background: Germ cell tumors are histologically heterogeneous group of tumors with high cure rate if \ndiagnosed early. The aim of study was to evaluate the extracranial germ cell tumors presenting to our \ninstitute with regards to gender, age, clinical presentation, pathology, management, acute toxicity and \nsurvival. \nMaterial and Methods: This retrospective study was conducted at Department of Radiation Oncology, All \nIndia Institute of Medical Sciences (AIIMS), Patna. \nResults: Total of 75 patients with germ cell tumor (GCT) were analysed. Distribution of males and females \nwere 50.7% and 49.3% respectively. The median age of presentation of males and females was 31 years and \n15 years respectively. At the time of presentation, 47.3% male and 16.2% of female patients had metastatic \ndisease. The median alpha-fetoprotein (AFP), beta subunit of human chorionic gonadotropin (?HCG), and \nlactate dehydrogenase (LDH) were 112 ng/ml, 668 mIU/ml, and 550 U/L respectively. At median followup of 34 months, 32% of the patient developed recurrence. The median disease-free survival (DFS) and \noverall survival (OS) were 57 months and 71 months respectively. Multivariate analysis showed that the \nhistological subtypes (p = 0.001) and risk groups (p = 0.029) were the independent prognostic factors for \nDFS, while metastatic status at presentation (p = 0.037), upfront surgical intervention (p =0.039), and \nhistopathological subtypes (p = 0.009) were the independent prognostic factor for OS. \nConclusion: GCT is primarily a disease of young and adolescents. Early diagnosis, well-orchestrated \nmultidisciplinary management leads to favourable outcome and survival.