Modified grading system for clinical outcome of intracranial non-germinomatous malignant germ cell tumors
Modified grading system for clinical outcome of intracranial non-germinomatous malignant germ cell tumors
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DOI：
10.3892/ol_00000111
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发表时间：
2010-07-01
期刊：
影响因子：
2.9
通讯作者：
Zhou, Liang-Fu
中科院分区：
文献类型：
--
作者：
Huang, Xiang;Zhang, Rong;Zhou, Liang-Fu
本文回顾了复旦大学附属上海华山医院收治的经组织学证实的颅内非生发性恶性生殖细胞瘤（ngmgct）的临床结果，分析了39例ngmgct的临床资料，其中混合性生殖细胞瘤15例，未成熟畸胎瘤15例，胚胎癌7例，卵黄囊瘤2例。部分患者还接受了伽玛刀手术，常见5年生存率为36.8%，根据Matsutani分级系统，中、差预后组患者的5年精算生存率分别为45.8%和14.3%，各类型肿瘤的个体分析显示，胚胎癌的中位生存时间为27个月；与中间组（28个月）非常接近，因此我们将胚胎癌分类为中间组，新中间预后组患者的5年精算生存率为42.6%。进一步分析未成熟畸胎瘤病例发现，未成熟畸胎瘤患者接受伽玛刀手术的5年生存率为100%，与未接受伽玛刀手术的患者相比，这一比例有显著差异（P= 0.0049）综上所述，我们认为手术是治疗的首选，但对于不同的组织学，肿瘤类型应分别治疗
This study investigated the clinical outcome of intracranial non-germinomatous malignant germ cell tumors (NGMGCTs) All histologically proven cases of NGMGCTs treated in Shanghai Huashan Hospital, Fudan University were reviewed A total of 39 cases were analyzed There were 15 mixed germ cell tumors, 15 immature teratomas, 7 embryonal carcinomas and 2 yolk sac tumors Patients were treated surgically first, followed by radiotherapy and/or chemotherapy Some patients also received gamma knife surgery The common 5-year survival rate was 36 8% According to Matsutani's grading system, the 5-year actuarial survival rate for patients in the intermediate and poor prognosis groups were 45 8 and 14 3%, respectively Individual analysis of each type of tumor showed that the median survival time of embryonal carcinoma was 27 months, which is very close to that of the intermediate group (28 months) We therefore classified embryonal carcinoma into the intermediate group where the 5-year actuarial survival rate for patients in the new intermediate prognosis group was 42 6% Further analysis of immature teratoma cases found that the 5-year survival rate of patients with immature teratoma who received gamma knife surgery is 100% This rate exhibited a significant difference (P=0 0049) compared to that of patients who did not undergo gamma knife surgery In conclusion, we consider surgery as the first choice of treatment although for different histologis, the type of the tumor should be treated separately