Advanced Extragonadal Germ-Cell Tumors

Thirty-two patients with primary extragonadal germ-cell tumors were treated at Vanderbilt and Indiana University Hospitals during the period from 1976 to 1981. Thirty-one patients had far-advanced disease when treatment was begun. All patients received intensive cisplatincontaining combination chemotherapy regimens. Tumors remaining after chemotherapy were surgically removed when feasible. Of the 31 evaluable patients, 18 have been continuously disease-free after therapy, 21 patients had a complete remission; the remaining 10 had partial response. Eighty-nine percent of patients with complete remission remain free of disease after median follow-up of 30 months. No relapses occurred after 12 months of complete remission. Patients with partial response had a median survival of 9 months with no long-term survivors. Response rates and survival are similar to patients with advanced-stage testicular germ-cell tumors. Extragonadal germ-cell tumors are as curable as testicular germ-cell tumors when treated with intensive cisplatin-containing combination chemotherapy regimens, and Surgical resection when necessary.