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Advances in Urology
Volume 2017 (2017), Article ID 1404610, 6 pages
https://doi.org/10.1155/2017/1404610
Clinical Study

A Study of Patients with Primary Mediastinal Germ Cell Tumors Treated Using Multimodal Therapy

1Department of Urology, Anjo Kosei Hospital, Anjo, Japan
2Department of Nephro-Urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

Correspondence should be addressed to Takehiko Okamura; pj.afummoc.fs@6452okih

Received 24 October 2016; Revised 11 February 2017; Accepted 8 March 2017; Published 28 May 2017

Academic Editor: Fabio Campodonico

Copyright © 2017 Yutaro Tanaka et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. Primary mediastinal germ cell tumors (PMGCTs) are rare, which often makes them difficult to treat. Herein, we examined patients with PMGCTs who underwent multimodal treatment. Methods. We examined 6 patients (median age: 25 years, range: 19–27 years) with PMGCTs who underwent multimodal treatment between April 2001 and March 2015. Three patients had seminomas, 2 patients had yolk sac tumors, and 1 patient had choriocarcinoma. The median observation period was 32.5 months (range: 8–84 months). Results. Three of the 6 patients received initial operation followed by 3-4 courses of chemotherapy (bleomycin, etoposide, and cisplatin (BEP) or etoposide and cisplatin (EP)). One patient developed multiple lung metastases 17 months after surgery; received salvage chemotherapy with vinblastine, ifosfamide, and cisplatin; and achieved complete remission. The remaining 3 patients received initial BEP and EP chemotherapy. Multiple lung metastases and supraclavicular lymph node metastases were detected in 2 of these patients at the initial diagnosis. The patients underwent resections to remove residual tumor after treatment, and no viable tumor cells were found. Conclusions. Reliable diagnosis and immediate multimodal treatments are necessary for patients with PMGCTs. The 6 patients treated in our hospital have never experienced recurrence after the multimodal treatment.