Second-line high-dose chemotherapy in patients with mediastinal and retroperitoneal primary non-seminomatous germ cell tumors: The EBMT experience

Ugo De Giorgi*, T. Demirer, H. Wandt, C. Taverna, W. Siegert, M. Bornhauser, T. Kozak, G. Papiani, M. Ballardini, G. Rosti, M. Marangolo, G. Ehninger, M. Suttorp, Carl Gustav Carus, D. Lutz, A. P. Schwarer, A. Thyss, H. Ludwig, G. Baumgartner, B. LioureA. Gratwohl, B. Hertenstein, K. Welte, R. Blasczyk, Y. Beguin, B. Metzner, K. Orchard, J. Garcia-Conde, C. Devalck, A. D. Moicean, R. Marcus, S. McCann, S. A. Schey, G. Juliusson, S. Lenhoff, K. Kolbe, E. Morra, J. F. Rossi, I. Yaniv, V. Koza, M. Freund, M. Bjorkholm, H. Greinix, W. Hinterberger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Results of second-line chemotherapy in patients with extragonadal non-seminomatous germ cell tumor (NSGCT) appear inferior to results in testicular NSGCT. Patients with retroperitoneal NSGCT achieve a comparable long-term survival rate of 30%, but the salvage rates of patients with mediastinal primary are less than 10%. We conducted a retrospective analysis on patients with mediastinal and retroperitoneal NSGCT treated with second-line high-dose chemotherapy (HDCT) registered with the European Group for Blood and Marrow Transplantation (EBMT). Patients and methods: Between 1987 and 1999, 59 registered patients with retroperitoneal (n=37) and mediastinal (n=22) primary NSGCT, median age 28 years (range 18-60), were treated with second-line HDCT. All had received cisplatin-containing chemotherapy as first-line treatment. Results: Toxic death occurred in three cases (5%). With a median follow-up of 58 months (range 14-114), 18/59 patients (30%) continue to be disease-free. Of three patients who had a disease recurrence after HDCT, one patient achieved a disease-free status with further chemotherapy and surgery. In total, 19 patients (32%) are currently disease-free. Sixteen of 37 patients (43%) with retroperitoneal NSGCT, and three of 22 patients (14%) with mediastinal NSGCT are currently alive and disease-free. Conclusions: Second-line HDCT might represent a possible option for patients with retroperitoneal primary NSGCT. New salvage strategies are needed for patients with mediastinal NSGCT.

Original languageEnglish
Pages (from-to)146-151
Number of pages6
JournalAnnals of Oncology
Issue number1
StatePublished - Jan 2005
Externally publishedYes


  • EBMT
  • Extragonadal
  • High-dose chemotherapy
  • Non-seminomatous germ cell tumor
  • Second-line chemotherapy


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