Post-Chemotherapy Resection of Nonseminomatous Germ Cell Testicular Tumors Metastatic to the Mediastinum

AbstractPurpose: We determined if the behavior of germ cell tumors metastatic to the mediastinum is different from that of primary mediastinal germ cell tumors, a group known to have distinct clinical features.Materials and Methods: A search of the computerized data base for germ cell tumors metastatic to the mediastinum at our university revealed 80 patients, 65 of whom underwent concomitant retroperitoneal lymph node dissection at mediastinal surgery.Results: Of the patients 60 (75 percent) are free of disease, 14 (18 percent) died of cancer and 6 (8 percent) are living with disease. Mediastinal pathology included teratoma in 65 percent of the patients, cancer in 26 percent and fibrosis in 9 percent. Of the 65 patients who underwent retroperitoneal lymph node dissection 75 percent had teratoma, 15 percent had fibrosis and 10 percent had cancer. Mediastinal relapses after dissection were rare (4 of 80 patients).Conclusions: Germ cell tumors metastatic to the mediastinum appear to behave similarly to thos...