XXXX of the mediastinum and retroperitoneum: results from an international analysis.

@entity1 @entity2971 @entity5 @entity1764 @entity8678 @entity10711 @entity1583 @entity4797 @entity902
PURPOSE: To characterize the clinical and biologic features of @entity2971 ( @entity2971 ) and to determine the overall outcome with currently available treatment strategies. @entity1 AND METHODS: Of an unselected population of 635 consecutive @entity1 treated from 1975 through 1996 at 11 @entity5 centers, 341 @entity1 (54%) had primary mediastinal @entity2971 , and 283 @entity1 (45%) had retroperitoneal @entity2971 . Five hundred twenty-four @entity1 (83%) had a @entity10711 ( @entity2971 ), and 104 @entity1 (16%) had a seminomatous histology. RESULTS: After @entity902 -based induction chemotherapy with or without secondary surgery, 141 @entity1 (49%) with @entity1764 (median follow-up, 19 months; range, 1 to 178 months) and 144 @entity1 (63%) with @entity8678 (median follow-up, 29 months; range, 1 to 203 months) are alive (P =.0006). In contrast, the overall survival rate for @entity1 with a seminomatous @entity2971 is 88%, with no difference between @entity1 with mediastinal or retroperitoneal @entity5 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 @entity4797 @entity1 treated with initial radiotherapy alone compared with chemotherapy. Nonseminomatous histology, presence of nonpulmonary visceral metastases, primary mediastinal @entity2971 location, and elevated beta- @entity1 chorionic gonadotropin were independent prognostic factors for shorter survival. @entity1583 (n = 17) occurred without exception in @entity1 with primary mediastinal nonseminoma. Sixteen @entity1 developed a metachronous @entity5 despite the use of @entity902 -based chemotherapy. CONCLUSION: Whereas @entity1 with pure seminomatous @entity2971 histology have a long-term chance of cure of almost 90% irrespective of the primary @entity5 site, 45% of @entity1 with @entity1764 are alive at 5 years. This outcome is clearly inferior compared with @entity1 with @entity5 .
