{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:39:28Z","timestamp":1792028368867,"version":"4.4.0"},"reference-count":42,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2002,4,1]]},"abstract":"<jats:p>PURPOSE: To characterize the clinical and biologic features of extragonadal germ cell tumor (EGCT) and to determine the overall outcome with currently available treatment strategies.<\/jats:p>\n                  <jats:p>PATIENTS AND METHODS: Of an unselected population of 635 consecutive patients treated from 1975 through 1996 at 11 cancer centers, 341 patients (54%) had primary mediastinal EGCT, and 283 patients (45%) had retroperitoneal EGCT. Five hundred twenty-four patients (83%) had a nonseminomatous germ cell tumor (GCT), and 104 patients (16%) had a seminomatous histology.<\/jats:p>\n                  <jats:p>RESULTS: After platinum-based induction chemotherapy with or without secondary surgery, 141 patients (49%) with mediastinal nonseminomas (median follow-up, 19 months; range, 1 to 178 months) and 144 patients (63%) with retroperitoneal nonseminoma (median follow-up, 29 months; range, 1 to 203 months) are alive (P = .0006). In contrast, the overall survival rate for patients with a seminomatous EGCT is 88%, with no difference between patients with mediastinal or retroperitoneal tumor location (median follow-up, 49 months; range, 4 to 193 months; respective 70 months; range, 1 to 211 months). A significantly lower progression-free survival rate was found in seminoma patients treated with initial radiotherapy alone compared with chemotherapy. Nonseminomatous histology, presence of nonpulmonary visceral metastases, primary mediastinal GCT location, and elevated beta-human chorionic gonadotropin were independent prognostic factors for shorter survival. Hematologic malignancies (n = 17) occurred without exception in patients with primary mediastinal nonseminoma. Sixteen patients developed a metachronous testicular cancer despite the use of platinum-based chemotherapy.<\/jats:p>\n                  <jats:p>CONCLUSION: Whereas patients with pure seminomatous EGCT histology have a long-term chance of cure of almost 90% irrespective of the primary tumor site, 45% of patients with mediastinal nonseminomas are alive at 5 years. This outcome is clearly inferior compared with patients with nonseminomatous retroperitoneal primary tumors.<\/jats:p>","DOI":"10.1200\/jco.2002.07.062","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T09:13:48Z","timestamp":1027761228000},"page":"1864-1873","source":"Crossref","is-referenced-by-count":413,"title":["Extragonadal Germ Cell Tumors of the Mediastinum and Retroperitoneum: Results From an International Analysis"],"prefix":"10.1200","volume":"20","author":[{"given":"Carsten","family":"Bokemeyer","sequence":"first","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig R.","family":"Nichols","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-P.","family":"Droz","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-J.","family":"Schmoll","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Horwich","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Gerl","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie D.","family":"Fossa","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Beyer","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Pont","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lothar","family":"Kanz","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Einhorn","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; Klinikum Gro\u03b2hadern, Munich; Virchow Klinikum, Berlin; and University of Halle, Halle, Germany; Oregon Health Sciences University, Portland, OR; Centre L\u00e9on-Berard, Groupe d\u2019Etude des Tumeurs Urologiques et Genitales, Lyon, France; Royal Marsden Hospital, Sutton, United Kingdom; Norwegian Radium Hospital, Oslo, Norway; Kaiser Franz Josef Spital, Vienna, Austria; and Indiana University, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg T.","family":"Hartmann","sequence":"additional","affiliation":[{"name":"From the Tuebingen University Medical Center II, Tuebingen; 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