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. 2022 Aug 1;24(8):1389-1399.
doi: 10.1093/neuonc/noab295.

Outcomes of intracranial germinoma-A retrospective multinational Asian study on effect of clinical presentation and differential treatment strategies

Kyung-Nam Koh  1 , Ru Xin Wong  2 , Dong-Eun Lee  3 , Jung Woo Han  4 , Hwa Kyung Byun  5 , Hong In Yoon  5 , Dong-Seok Kim  6 , Chuhl Joo Lyu  4 , Hyoung Jin Kang  7 , Kyung Taek Hong  7 , Joo Ho Lee  8 , Il Han Kim  8 , Ji Hoon Phi  9 , Seung-Ki Kim  9 , Tai-Tong Wong  10 , Hsin-Lun Lee  11 , I-Chun Lai  10 , Yu-Mei Kang  10 , Young-Shin Ra  12 , Seung Do Ahn  13 , Ho Joon Im  1 , Wen Shen Looi  2 , Sharon Yin Yee Low  14   15 , Enrica Ee Kar Tan  16 , Hyun Jin Park  17 , Sang Hoon Shin  18 , Hiroshi Fuji  19 , Chang-Ok Suh  20 , Yi-Wei Chen  21 , Joo-Young Kim  22
Affiliations

Outcomes of intracranial germinoma-A retrospective multinational Asian study on effect of clinical presentation and differential treatment strategies

Kyung-Nam Koh et al. Neuro Oncol. .

Abstract

Background: This multinational study was conducted to report clinical presentations and treatment strategies in patients with intracranial germinomas across selected Asian centers, including failure patterns, risk factors, and outcomes.

Methods: A retrospective data collection and analysis of these patients, treated between 1995 and 2015 from eight healthcare institutions across four countries was undertaken.

Results: From the results, 418 patients were analyzed, with a median follow-up of 8.9 years; 79.9% of the patients were M0, and 87.6% had β-human chorionic gonadotropin values <50 mIU/mL. The 5/10-year overall survival (OS) and recurrence-free survival (RFS) rates were 97.2%/96.2% and 89.9%/86.9%, respectively. RFS was predicted by the radiotherapy (RT) field, with focal RT having the worst outcome, whereas chemotherapy usage had no impact on survival. Among patients who received chemotherapy, response to chemotherapy did not predict survival outcomes. In M0 patients, primary basal ganglia tumors predicted a worse RFS. In patients with bifocal tumors, an extended field RT was associated with better outcomes. In multivariable analysis, only RT fields were associated with RFS. In relapsed patients, salvage rates were high at 85.7%. Additionally, patients who received salvage RT had a better outcome (91.6% vs. 66.7%).

Conclusions: Survival outcomes of patients with germinoma were excellent. Thus, the focus of treatment for intracranial germinoma should be on survivorship. Further studies are warranted to find the optimal intensity and volume of radiation, including the role of chemotherapy in the survival of patients with intracranial germinomas, considering age, primary tumor location, and extent of disease.

Keywords: chemotherapy; intracranial germinoma; outcomes; radiotherapy; treatment.

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Figures

Fig. 1
Fig. 1
Survival outcomes of patients diagnosed with intracranial germinoma. A. Overall survival and B. recurrence-free survival according to metastasis.
Fig. 2
Fig. 2
Survival outcomes of patients diagnosed with intracranial germinoma according to radiation volume. A. Overall survival and B. recurrence-free survival of patients without metastasis. C. overall survival and D. recurrence-free survival of patients with metastasis according to radiation volume.
Fig. 3
Fig. 3
Survival outcomes of patients diagnosed with intracranial germinoma according to primary tumor sites. A. Overall survival and B. recurrence-free survival of patients without metastasis according to primary tumor sites. C. Overall survival and D. recurrence-free survival with an indication of recurrence sites in patients with bifocal tumors according to radiation volume.
See this image and copyright information in PMC

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