Clinicopathological features and management of patients with primary malignant mediastinal germ cell tumor: 10 year’s experience in Peruvian patients.

e13088 Background: Primary malignant mediastinal germ cell tumor (PMMGCT) are rare and have poor prognosis with particularly different biology from those of other germ cell tumor. The aim of this study was to evaluate the clinicopathological features, different types of treatment response and survival these patients. Methods: Forty-six patients with PMMGCT who were treated at the Instituto Nacional de Enfermedades Neoplasicas, from 2003 to 2012. Overall survival (OS) curves were estimated using the Kaplan-Meier method and comparisons were done using the log-rank test. A p-value < 0.05 was considered statistically significant. Results: Forty-six men and 2 women with a median age of 23 [range: 3-68] were identified, of whom 17 (35.4%) had pure seminoma, 11 (22.9%) had non-seminomatous, 11 (22.9%) had mixed histology and 9 (18.8%) were not determined of histologic type. Thirty-one (64.6%) had tumor located at mediastinum, 7 (14.6%) had lung metastases and /or effusion and 10 (20.8%) had distant metastases. Thirty-five (72.9%) patients received chemotherapy (ChT) first, 6 (12.5%) underwent surgical resection followed by ChT, 2 (4.2%) concurrent ChT and radiotherapy (RT), 1 (2.1%) RT followed by ChT and 4 (8.3%) no treatment. Twenty eight (63.6%) achieved objective response, 22 (50%) underwent surgery after ChT consolidation of which 17 (77.2%) were negative for tumor histology. The 5-yrs median progression-free survival was 73.4% and overall survival was 60.1%. By univariate analysis was determined that the high level of AFP at diagnosis (p = 0.002) and surgical consolidation (p = 0.042) were prognostic factors for OS and PFS. Conclusions: Young men were the most affected population. The mediastinum restricted location and pure seminoma histology are more frequent. The high level of AFP and surgical resection were significant factors for survival but not independently.