A retrospective analysis was performed on all patients diagnosed with biopsyproven extragonadal germ cell tumors at the University of Virginia (Charlottesville, VA), The Medical University of South Carolina (Charleston, SC), the Bethesda Naval Hospital (Bethesda, MD), and The Medical College of Virginia (Richmond, VA) for the time period of January 1965 to December 1984. A total of 54 patients were treated with the initial sites of presentation observed: mediastinum, 26; central nervous system, 14; retroperitoneum, eight; and sacrococcygeal region, six. Megavoltage irradiation was used in 44 patients with a dose range of 2400 to 5580 cGy (mean, 4213 cGy). With a minimum follow-up of 4.0 years and a mean followup of 10.8 years, the 5-year actuarial survival for the entire population was 57.8%.
Local control was achieved in 26 of 44 (59%) of the irradiated population. Factors of prognostic significance included histologic type at presentation, site of presentation, and radiation doses greater than or equal to 4000 cGy. Radiotherapy appears to be an effective modality in patients with extragonadal seminomas; however, the nonseminomatous tumors do not appear to be as radioresponsive. Cancer 652681-2685,1990.
RIMARY EXTRAGONADAL germ Cell tumors are an P extremely rare neoplasm that account for 1 % to 4% of all germ cell tumors.' Although surgical therapy is often attempted, total surgical resection is often difficult or impossible due to large tumor volume or an inaccessible location of the primary lesion.2 Radiation therapy and/ or chemotherapy is often advocated once the diagnosis has been established.