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 diagnosed early. The aim of study was to evaluate the extracranial germ cell tumors presenting to our institute with regards to gender, age, clinical presentation, pathology, management, acute toxicity and survival. Material and Methods: This retrospective study was conducted at Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Patna. Results: Total of 75 patients with germ cell tumor (GCT) were analysed. Distribution of males and females were 50.7% and 49.3% respectively. The median age of presentation of males and females was 31 years and 15 years respectively. At the time of presentation, 47.3% male and 16.2% of female patients had metastatic disease. The median alpha-fetoprotein (AFP), beta subunit of human chorionic gonadotropin (βHCG), and lactate 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 overall survival (OS) were 57 months and 71 months respectively. Multivariate analysis showed that the histological subtypes (p = 0.001) and risk groups (p = 0.029) were the independent prognostic factors for DFS, while metastatic status at presentation (p = 0.037), upfront surgical intervention (p =0.039), and histopathological subtypes (p = 0.009) were the independent prognostic factor for OS. Conclusion: GCT is primarily a disease of young and adolescents. Early diagnosis, well-orchestrated multidisciplinary management leads to favourable outcome and survival.