Prognostic factor of distal bile duct cancer (DBDC) and ampullary cancer (AC) after pancreatoduodenectomy.

333 Background: Ampullay cancer (AC) is relatively good prognosis in the biliary tract cancer. Such as LN metastasis, pancreatic invasion is a prognostic factor in AC. On the other hand, Distal bile duct cancer (DBDC) is somewhat good prognosis in the biliary tract cancer. Such as ductal resection margin positive is a prognostic factor in DBDC. There are few papers considered to both difference. Therefore, we conducted this study to examine the difference of AC and DBDC. Methods: To evaluate Cancer-Specific Survival (CaSS), Recurrence-Free Survival (RFS) and prognostic factors after pancreatoduodenectomy (including pylorus-preserving pancreatoduodenectomy: PPPD, subtotal stomach-preserving pancreatoduodenectomy: SSPPD) based on a series of 80 patients of AC and 36 patients of DBDC from 1996 to 2015. We reviewed and analyzed the clinicopathologic data, recurrence and survival. Results: Five years CaSS and RFS of AC were 72.3% and 72.5%. In univariate analysis, pancreatic invasion, R1or R2 resection, duodenal invasion and lymph node metastasis are significantly poor prognosis. In multivariate analysis, pancreatic invasion and R1or R2 resection are poor prognostic factors (pancreatic invasion, p = 0.0012, hazard ratio (HR) 5.65 [confidence interval (CI) 1.92-19.5 95%], R1or R2 resection, p = 0.0043, HR 6.22 [CI 1.68-40.2 95%]). On the other hand, five years CaSS and RFS of DBDC were 35.8% and 46.8%. In univariate analysis, pancreatic invasion (+) ≥ 5 mm in depth, and duodenal invasion are significantly poor prognosis. In multivariate analysis, duodenal invasion is the only poor prognostic factors (p = 0.0227, HR 2.90 [CI 1.16-7.39 95%]). Conclusions: DBDC is considerable poor prognosis compared with AC. Lymph node metastasis is not prognostic factor depends on D2 LN dissection in AC, than pancreatic invasion. Cancer cells invaded pancreatic parenchyma in AC; pancreatic invasion may be the most important prognostic factor by biology-like pancreatic cancer. Duodenal invasion in DBDC was prognostic factor reflects the degree of development of the cancer beyond pancreatic parenchyma. Further clinicopathological and biological studies are needed to confirm our findings.

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Prognostic factor of carcinoma of the ampulla of vater after surgery.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.270 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 270-270 ◽

Cited By ~ 1

Author(s):

Shinjiro Tomiyasu ◽

Eri Oda ◽

Hiroshi Tanaka ◽

Shinji Ishikawa ◽

Hiroki Sugita ◽

...

Keyword(s):

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Tnm Stage ◽

Tract Cancer ◽

Node Metastasis ◽

Duodenal Invasion ◽

Pancreatic Invasion

270 Background: General rules for biliary tract cancer in Japan were revised and Stage of biliary tract cancer was compliant with the seventh UICC. Carcinoma of the Ampulla Vater (CAV) is relatively good prognosis among the biliary tract cancer, such as lymph node metastasis, pancreatic invasion and perineural invasion has been reported to be prognostic factors. We investigated the validity of TNM-Stage by examining the prognostic factors from the outcome of resection experienced. Methods: To evaluate prognostic factors after surgery based on a series of 70 patients of CAV from 1996 to 2014. Twenty-eight patients received pancreatoduodenectomy (PD), 25 patients received pylorus-preserving pancreatoduodenectomy (PPPD) and 17 patients received subtotal stomach-preserving pancreatoduodenectomy (SSPPD). We reviewed and analyzed the clinicopathologic data, surgical outcomes, recurrence and survival. Results: Actuarial disease-specific survival (DSS) was 65 % at five years. In univariate analysis, pancreatic invasion, lymph node metastasis and duodenal invasion are significantly poor prognosis. In multivariate analysis, pancreatic invasion is the only poor prognostic factor (p = 0.0023, hazard ratio (HR) 5.31 [confidence interval (CI) 1.77-18.9 95%]); lymph node metastasis and duodenal invasion are not significantly different (p = 0.0672 and 0.8769, respectively). Also, in the study of relapse risk factors, pancreatic invasion and lymph node metastasis are significantly different. In TNM-Stage II, those of T3N0, 1 are poor prognosis than T1, 2N1 (p = 0.0334). Conclusions: Pancreatic invasion is an independent poor prognostic and recurrence risk factor. The Stage of Japanese Society of Biliary Surgery has reflect prognosis than TNM-Stage in carcinoma of the Ampulla Vater.

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Prognostic factors in patients with advanced renal carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.391 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 391-391

Author(s):

C. Muriel ◽

E. Esteban ◽

A. Astudillo ◽

P. Martinez-Camblor ◽

N. Corral ◽

...

Keyword(s):

Prognostic Factors ◽

Prognostic Factor ◽

Retrospective Cohort ◽

Poor Prognosis ◽

Renal Carcinoma ◽

Good Prognosis ◽

Biological Agents ◽

Enhanced Expression ◽

Favorable Prognostic Factor ◽

Low Expression

391 Background: A retrospective cohort of 135 patients with advanced RCC treated with biological agents and/or cytokines (CK) was analysed between July 1996 and February 2010. Methods: The expression of several biomarkers by immunohistochemistry and 2 analytical variables: thrombocytosis and neutrophilia were analysed and were correlated with prognosis. Results: 67 patients were treated only with biological agents and 68 with CK (23 received also biological agents). The univariate statistical analysis showed that the enhanced expression of HIF-1alpha correlated with a poor prognosis in patients treated with sunitinib (PFS was 5.4 vs. 13.4 months in those with low expression, p=0.001). The overexpression of ACIX was associated to a better prognosis in patients that received biological agents (PFS was 18.3 vs. 5.2 months in those with decreased expression, p<0.001; OS was 32.1 vs. 7.8 months, p<0.001), including sunitinib (PFS was 16.8 vs. 5.5 months, p<0.001), sorafenib (PFS was 8 vs 3.5 months, p<0.001)) and CK (PFS was 6.3 vs. 2.7 months, p=0.003; OS was 32.9 vs. 5.9 months, p=0.001). Positive PTEN was related to a good prognosis in patients treated with sunitinib (PFS was 15.1 vs. 6.5 months, p=0.003) and CK (PFS was 7.5 vs. 3.8 months, p=0.037, OS was 13.7 vs 7.9 months, p=0.039). The increased expression of p21 was related to a poor prognosis in patients that received biological agents (PFS was 5.9 vs. 16.8 months with high expression, p=0.024), including sunitinib (PFS was 6.2 vs 18.9 months, p<0.001), sorafenib (PFS was 4 vs 9 months, p=0.013) and CK (PFS was 3.9 vs. 7.5 months, p<0.001). Thrombocytosis was related to a poor prognosis in patients treated with CK (PFS was 2.6 vs. 5.1 months p=0.017; OS was 5.9 vs. 14.3 months p=0.010). Neutrophilia was related to a poor prognosis in patients that received CK (PFS was 2.6 vs. 5.7 months, p=0.019; OS was 5.9 vs. 12.8 months, p=0.035). In the multivariate analysis, the overexpression of ACIX was a favorable prognostic factor independent of PFS with a HR of 0.107 (p<0.001) and OS with a HR of 0.055 (p<0.001). Conclusions: Our experience has suggested the utility of de HIF-1alpha, ACIX, PTEN, p21, thrombocytosis and neutrophilia as prognostic factors in patients with advanced RCC. ACIX has shown to be an independent prognostic factor. No significant financial relationships to disclose.

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Analysis of Thin Malignant Melanoma Prognostic Factors

10.47363/jcrr/2020(2)122 ◽

2020 ◽

pp. 1-7

Author(s):

Gaetana Rizzi ◽

Keyword(s):

Prognostic Factors ◽

Malignant Melanoma ◽

Prognostic Factor ◽

Plastic Surgery ◽

Univariate Analysis ◽

Outcome Study ◽

Vertical Growth ◽

Malignant Melanomas ◽

Chi Squared ◽

Metastasis Development

The increasing number of thin malignant melanomas (≤1 mm in thickness) asks for better acknowledgement of prognostic factors of the disease; this is the purpose of this research [1, 2]. The plastic surgery unit of the hospital Spedali Civili of Brescia has collected over 450 cases of thin malignant melanoma over a period of 20 years, from 1990 to 2010, in order to obtain as much information as possible about prognostic factors. These data have been analyzed using the Chi-squared test to reveal the influence on prognosis of each one of the 16 prognostic factors that have been chosen for this study; both the development of a metastasis and the death of the patient were considered for outcome study. The univariate analysis describes the presence of the phase of vertical growth as the only prognostic factor statistically significant for both metastasis development and death.

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Expression of the Caudal-Type Homeodomain Transcription Factors CDX 1/2 and Outcome in Carcinomas of the Ampulla of Vater

Journal of Clinical Oncology ◽

10.1200/jco.2005.03.068 ◽

2005 ◽

Vol 23 (9) ◽

pp. 1811-1818 ◽

Cited By ~ 43

Author(s):

Donna E. Hansel ◽

Anirban Maitra ◽

John W. Lin ◽

Michael Goggins ◽

Pedram Argani ◽

...

Keyword(s):

Transcription Factors ◽

Prognostic Factors ◽

Univariate Analysis ◽

Ampulla Of Vater ◽

Good Prognosis ◽

Intestinal Epithelial ◽

Vascular Space ◽

Independent Marker ◽

Vascular Space Invasion ◽

Homeodomain Transcription Factors

Purpose Adenocarcinomas of the ampulla of Vater demonstrate a characteristic histology but vary significantly in outcome. As a consequence, prognostic factors for these cancers are poorly defined. The caudal-type homeodomain transcription factors 1 (CDX1) and 2 (CDX2) regulate axial development and intestinal differentiation. We assessed the expression of these putative intestinal epithelial-specific transcription factors and their influence on patient outcome. Patients and Methods Fifty-three resected carcinomas of the ampulla of Vater, 31 pancreatic ductal adenocarcinomas, and 15 extrahepatic biliary carcinomas were analyzed for CDX1 and CDX2 expression using immunohistochemistry. Results Forty percent of carcinomas of the ampulla of Vater but less than 5% of pancreatic and biliary adenocarcinomas expressed CDX. Expression of CDX was associated with a better prognosis (P = .0009). Individually, both CDX1 (P = .02) and CDX2 (P = .02) expression were associated with a survival advantage on univariate analysis. Advanced T stage (P = .02), lymph node metastases (P = .004), and vascular space invasion (P = .0009) were associated with a poor prognosis. Multivariate analysis revealed vascular space invasion (P = .01) and CDX expression (P = .01) to be independent prognostic factors. Conclusion Expression of CDX was an independent marker of outcome in patients with resected adenocarcinoma of the ampulla of Vater. Expression of CDX may distinguish good prognosis intestinal-like tumors, which potentially arise within intestinal epithelium, from poorer prognosis pancreatobiliary tumors, which arise in adjacent pancreatic and/or biliary ductal epithelium.

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Can we identify a group of breast cancer patients with a good prognosis despite four or more positive (4+) axillary nodes using a tissue microarray (TMA)?

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.10582 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 10582-10582

Author(s):

S. J. Crabb ◽

C. D. Bajdik ◽

C. H. Speers ◽

D. G. Huntsman ◽

K. A. Gelmon

Keyword(s):

Breast Cancer ◽

Estrogen Receptor ◽

Prognostic Factors ◽

Statistical Significance ◽

Univariate Analysis ◽

Good Prognosis ◽

Axillary Lymph ◽

Long Term Outcome ◽

Cox Regression Analysis ◽

Axillary Nodes

10582 Background: Although breast cancer with 4+ axillary lymph nodes generally carries a poor prognosis, we hypothesized that a good prognostic subgroup of such patients would be identifiable by immunohistochemical (IHC) biomarkers. Methods: Patients with primary breast cancer with 4+ axillary nodes and no metastatic disease at diagnosis were identified from a large clinically annotated TMA of formalin-fixed paraffin-embedded archival breast cancers and analyzed for eight IHC based biomarkers: estrogen receptor, HER2, carbonic anhydrase IX, EGFR, CK 5/6, progesterone receptor, p53 and Ki67. Expression of each biomarker was scored 0 or 1 to indicate good or bad prognosis based on univariate analysis of relapse free survival (RFS). Patients were banded as having a total score of 0 (i.e. each biomarker predicted a good outcome), 1–4 or 5–8. Kaplan Meier and Cox regression analysis of RFS outcomes was performed. 10 year RFS for each band was compared to the mean of predicted outcomes based on the prognostic tool Adjuvant! ( www.adjuvantonline.com ). Results: 313 eligible patients were identified and complete data were available for 228. The subset of 228 was similar to the larger group of 313 with respect to RFS and conventional prognostic factors. 10 year RFS for the 228 patients was 39.5% (standard error, SE 3.4%). The subgroup of 37 (16%) scoring zero for all 8 biomarkers had a mean 10 year RFS of 77.6% (SE 7.0). Mean 10 year RFS for the bands scoring 1–4 (154 patients, 68%) and 5–8 (37 patients, 16%) were 34.9% (SE 4.1) and 19.0% (SE 6.9) respectively. Mean 10 year RFS predictions by Adjuvant! were 35.9% (SE 2.6), 34.5% (SE 1.2) and 34.3% (SE 2.3) respectively. In multivariate analysis with conventional prognostic factors, the banded biomarker score retained statistical significance for predicting RFS (p=0.0007) along with estrogen receptor status (p=0.03) and tumour size (p=0.01). Conclusions: This TMA biomarker panel identified a breast cancer subgroup with good prognosis despite extensive axillary node involvement. Long term outcome was markedly better than that predicted by conventional prognostic factors. If validated, treatment decisions and clinical trial stratification might be modified using this new score. No significant financial relationships to disclose.

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Cetuximab (CTX) in first-line treatment of elderly patients with metastatic colorectal cancer (mCRC), KRAS wild type: French multicentre prospective community-based registry and results.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.760 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 760-760

Author(s):

Laurent Mineur ◽

Eric François ◽

Jean Marc Phelip ◽

Rosine Guimbaud ◽

Carine Plassot ◽

...

Keyword(s):

Prognostic Factors ◽

Prognostic Factor ◽

Cox Regression ◽

Univariate Analysis ◽

Rank Test ◽

Wild Type ◽

Community Based ◽

Cox Models ◽

Cox Regression Analysis ◽

Effective Age

760 Background: Pts included in clinical trials represent the unusual population in mCRC. This study aims to provide oncologist with a better understanding of the potential benefit of CT with CTX in older patients with mCRC KRAS wild type and evaluate prognostic variables on the PFS including the age. Methods: Premium cancer study is a French multicentre prospective community-based registry. 493 pts enrolled and 487 included between September 2009 to March 2012 from 94 French centers and physicians. Pts had to provide written informed consent and protocol submitted to regulatory authorities. Predefined efficacy endpoints was PFS. CTX was administrated at 250 mg/m2 weekly (n=100; 20.3%) or 500 mg/m2 every 2 weeks (n=380;77,2%), other n=13; 2.5%) CT regimen choice was at physician’s discretion.. The main analysis is PFS as well as analysis of prognostic factors of this PFS (29 items including age (< 65 years n=229; 65-74 years n= 165.; ≥75years n=93). Univariate analysis was performed for each covariate, PFS was estimated by Kaplan-Meier curves and compared by log-rank test. univariable Cox regression analysis was used to assess the association between each variable and outcome. Multivariable stepwise Cox models were then fitted for final variable selection of prognostic factors on PFS. Results: Univariate significant prognostic factors for PFS are OMS (0-1 vs 2-3), Tobacco, Site of tumor (right vs other), Number of metastatic organ (1 vs 2-3), Resecability of metastatic disease defined before CT (definitively non resectable metastases vs possible resectable), Surgery of mCRC, folliculitis or xerosis or paronychia grade 0-1 vs 2-4. Age was unidentified as a prognostic factor in univariate analysis. Four factors were independently associated with a better PFS: xerosis [hazard ratio (HR0,651); 95% confidence interval (CI) 0,494-0,857], (WHO PS) 0–1 (HR0,519 ; 95% CI 0,371–0,726) and folliculitis (HR 0,711; 95% CI0,558–0,956) metastases surgery 0,287(CI 0,205-0,403). Conclusions: CTX in combination with standard CT is effective, age is not identified as a prognostic factor for the PFS. Both groups of pts based on age benefit from CTX.

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Clinical Features and Prognostic Factors of Acute Ischemic Stroke Related to Malignant Gastrointestinal Tumor

Frontiers in Neurology ◽

10.3389/fneur.2021.777483 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yating Liu ◽

Xin Li ◽

Feixue Song ◽

Xin Yan ◽

Zhijian Han ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Prognostic Factors ◽

Acute Ischemic Stroke ◽

Malignant Tumor ◽

Poor Prognosis ◽

Good Prognosis ◽

Imaging Features ◽

Prognosis Group ◽

D Dimer

Objectives: To analyze the clinical and imaging features of acute ischemic stroke (AIS) related to gastrointestinal malignant tumor, and to explore the prognostic factors.Methods: Clinical data of consecutive patients with gastrointestinal malignant tumor complicated with AIS admitted to the Department of Neurology and Oncology in Lanzhou University Second Hospital from April 2015 to April 2019 were retrospectively analyzed. Patients were divided into good prognosis (mRS 0–2) and poor prognosis (mRS > 2) based on a 90-day mRS score after discharge. The multivariate logistic regression model was used to analyze the prognostic factors.Results: A total of 68 patients were enrolled with an average age of 61.78 ± 6.65 years, including 49 men (72.06%). There were 18 patients in the good prognosis group and 50 patients in the poor prognosis group. The univariate analysis showed that Hcy, D-dimer, thrombin–antithrombin complex (TAT), and three territory sign in magnetic resonance imaging (MRI) were the risk factors for poor prognosis. Multivariate analysis showed that increased D-dimer (OR 4.497, 95% CI 1.014–19.938) and TAT levels (OR 4.294, 95% CI 1.654–11.149) were independent risk factors for the prognosis in such patients.Conclusion: Image of patients with gastrointestinal malignant tumor-related AIS is characterized by three territory sign (multiple lesions in different vascular supply areas). Increased TAT and D-dimer levels are independent prognostic risk factors. TAT is more sensitive to predict prognosis than D-dimer.

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Prognostic Factors of the Postoperative Pancreatic Carcinoma and Implications for Identification of Potential Long-term Survivors

10.21203/rs.2.18706/v1 ◽

2019 ◽

Author(s):

Wei Hu ◽

Jiao Zhou ◽

Wenbo Zhou ◽

Lun Wu ◽

Shaohua Sun ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Pancreatic Carcinoma ◽

Univariate Analysis ◽

Postoperative Mortality ◽

Proportional Hazard ◽

Node Metastasis ◽

Cox Proportional Hazard

Abstract Background Patients with Pancreatic cancer (PC) have worse survival than patients with any other gastrointestinal malignancy. In present study, it is aim to investigate the prognostic factors of pancreatic carcinoma after curative resection . Methods 72 cases suffered from pancreatic carcinoma or periampullary carcinoma received curative, nine clinicopathologic factors that could possibly influence survival for postoperative mortality and overall survival were selected for univariate analysis and multivariate analysis using Cox proportional hazard mode. Results Univariate analysis showed that major factors of influence survival were size of the tumor, lymph node metastasis, and grade of differentiation (P<0.05). Multivariate analysis showed that lymph node metastasis and size of the tumor were the most important prognostic factors by multivariate analysis using the Cox proportional hazard model (P<0.01). Conclusions Prognostic factors of pancreatic carcinoma after resection are closed related to lymph node metastasis and the size of the tumor.

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Prognostic significance of immunohistochemical markers in endometrial cancer treated with chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16551 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16551-e16551

Author(s):

S. R. Lord ◽

N. Vasudev ◽

S. Knight ◽

V. Speirs ◽

G. Hall

Keyword(s):

Endometrial Cancer ◽

Prognostic Factors ◽

Poor Prognosis ◽

Early Stage ◽

Good Prognosis ◽

Serous Carcinoma ◽

Positive Staining ◽

Endometrioid Adenocarcinoma ◽

Similar Frequency ◽

Early Stage Endometrial Cancer

e16551 Background: The proportion of patients receiving chemotherapy for endometrial cancer is increasing both in the adjuvant and advanced setting. The literature describes many prognostic immunohistochemical factors in early stage endometrial cancer, the majority of whom will not receive chemotherapy. The aim of this study was to describe the biomarker expression for endometrial tumours treated with chemotherapy and to assess what constitutes a favourable and unfavourable profile for this patient group. Methods: For a subset of patients with either endometrioid, serous or a mixed mullerian morphology treated with chemotherapy at our centre between 1996 and 2008 an immunohistochemical profile of 14 biomarkers was studied (ERα, Erβ1, Erβ2, PR, PRB, P53, Rb, E-cad, MDM2, MIB-1, E2F1, p16, p13, and p21). A univariate analysis using cox regression of potential prognostic factors was then carried out. Results: In total 199 patients received chemotherapy for endometrial cancer over the 12 year period studied. Two year survival from commencement of chemotherapy for patients receiving adjuvant treatment was 45.2% and palliative treatment 28.1%. The commonest histological subtypes were endometrioid adenocarcinoma (40%), serous carcinoma (24.1%) and mixed mullerian tumours (14.6%). For the subset of 35 patients 38.2% of patients had positive immunohistochemical staining for ERα, 53% for PR, 73.5% for p16, and 94% for E2F1. Good prognosis was predicted by the strength of staining for E2F1 (HR 0.757, CI 0.216/0.902, p = 0.025) and poor prognosis by p16 (HR 1.470, CI 1.040/2.077, p = 0.029). Conclusions: Positive staining for ERα and PR was of similar frequency to previous studies of early stage endometrial cancer and did not significantly influence prognosis. Good prognosis correlated with E2F1 expression and poor prognosis with p16. A greater proportion of patients had serous morphology compared to published series of early stage endometrial cancer. Further study of prognostic factors in larger numbers of patients and built into prospective randomised trials may allow the creation of a prognostic model and guide the development of future clinical trials of targeted therapy. No significant financial relationships to disclose.

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Clinical outcome of extragonadal germ cell tumors: Retrospective analysis at a single institution in Japan.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.5_suppl.345 ◽

2012 ◽

Vol 30 (5_suppl) ◽

pp. 345-345

Author(s):

Ken-Ichi Kakimoto ◽

Ken Takeda ◽

Wataru Nakata ◽

Masashi Nakayama ◽

Yasuyuki Arai ◽

...

Keyword(s):

Prognostic Factors ◽

Germ Cell ◽

Retrospective Analysis ◽

Univariate Analysis ◽

Germ Cell Tumors ◽

Multimodality Treatment ◽

Japanese Patients ◽

Good Prognosis ◽

Induction Treatment ◽

Extragonadal Germ Cell Tumors

345 Background: Extragonadal germ cell tumors (EGGCT) are very rare and account for only 2% to 5% of all malignant germ cell neoplasms. Although multimodality treatment, including cisplatin-based chemotherapy and postchemotherapy surgery, has improved the prognosis of patients with EGGCT, few findings are available for these tumors. We therefore performed a retrospective analysis of Japanese patients with EGGCT. Methods: We performed a retrospective review of the medical records of 34 male patients ranging in age from 18 to 62 years (median age, 30 years) treated at our institution between 1982 and 2010. Fifteen patients (44%) had primary mediastinal EGGCT, 16 patients (47%) had primary retroperitoneal EGGCT, and three patients (9%) had primary mediastinal and retroperitoneal EGGCT. Results: Twenty-six patients (76%) had nonseminomatous EGGCT, and eight patients (24%) had seminomatous histology. Surgical procedures were performed in five patients (15%) as induction treatment. Three of them had seminomatous histology and were continuously disease-free after adjuvant chemotherapy. Twenty-nine patients (85%) had received cisplatin-containing regimen as induction therapy. Twenty-three patients underwent post–chemotherapy surgery, and 14 of them (60%) had residual viable malignant cells. On univariate analysis, nonseminomatous EGGCT (P<0.01) and resistance to cisplatin (lack of achievement of CR/PRm- by induction chemotherapy; P<0.01) were identified as negative prognostic factors for survival. Twenty of 34 patients (59%) were alive without disease, and 13 patients with nonseminomatous histology died of disease progression. The overall 10-year survival rate for all patients was 53%. Conclusions: Patients with seminomatous EGGCT have a very good prognosis, while nonseminomatous histology and resistance to cisplatin were found to be negative prognostic factors.

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