Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases
Masao Matsutani
Masao Matsutani
Department of Neurosurgery, University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Saitama Medical School, Saitama, Japan; Departments of Neurosurgery and Pathology, Teikyo University School of Medicine, Tokyo, Japan; and Departments of Neurosurgery and Pathology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
Keiji Sano
Department of Neurosurgery, University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Saitama Medical School, Saitama, Japan; Departments of Neurosurgery and Pathology, Teikyo University School of Medicine, Tokyo, Japan; and Departments of Neurosurgery and Pathology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
Kintomo Takakura
Department of Neurosurgery, University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Saitama Medical School, Saitama, Japan; Departments of Neurosurgery and Pathology, Teikyo University School of Medicine, Tokyo, Japan; and Departments of Neurosurgery and Pathology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
Takamitsu Fujimaki
Department of Neurosurgery, University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Saitama Medical School, Saitama, Japan; Departments of Neurosurgery and Pathology, Teikyo University School of Medicine, Tokyo, Japan; and Departments of Neurosurgery and Pathology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
Osamu Nakamura
Department of Neurosurgery, University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Saitama Medical School, Saitama, Japan; Departments of Neurosurgery and Pathology, Teikyo University School of Medicine, Tokyo, Japan; and Departments of Neurosurgery and Pathology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
Nobuaki Funata
Department of Neurosurgery, University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Saitama Medical School, Saitama, Japan; Departments of Neurosurgery and Pathology, Teikyo University School of Medicine, Tokyo, Japan; and Departments of Neurosurgery and Pathology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
Terukazu Seto
Department of Neurosurgery, University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Saitama Medical School, Saitama, Japan; Departments of Neurosurgery and Pathology, Teikyo University School of Medicine, Tokyo, Japan; and Departments of Neurosurgery and Pathology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
✓ The authors analyzed 153 cases of histologically verified intracranial germ cell tumors. The histological diagnosis was germinoma in 63 patients (41.2%), teratoma in 30 (19.6%), and other types of tumors in 60 patients (39.2%). The patients were treated by a consistent policy of surgical removal with histological verification followed by radiation therapy with or without chemotherapy.
The 10- and 20-year survival rates of patients with pure germinoma were 92.7% and 80.6%, respectively. The 10-year survival rates of patients with mature teratoma and malignant teratoma were 92.9% and 70.7%, respectively. Patients with pure malignant germ cell tumors (embryonal carcinoma, yolk sac tumor, or choriocarcinoma) had a 3-year survival rate of 27.3%. The mixed tumors were divided into three subgroups: 1) mixed germinoma and teratoma; 2) mixed tumors whose predominant characteristics were germinoma or teratoma combined with some elements of pure malignant tumors; and 3) mixed tumors with predominantly pure malignant elements. The 3-year survival rates were 94.1% for the first group, 70% for the second group, and 9.3% for the third group, and the differences were statistically significant. Twenty-six patients with malignant tumors received chemotherapy that consisted of cisplatin and carboplatin combinations with or without radiation therapy. However, chemotherapy was not significantly more effective than radiation therapy alone.
From these treatment results, the authors classified tumors into three groups with different prognoses and proposed a treatment guideline appropriate for the subgroups.
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