Autologous stem cell transplantation in patients with extragonadal germ cell tumors: A single center experience

Aims: In extragonadal germ cell tumors (EGGCT), chemosensitivity and prognosis are worse than in GCT tumors. There is no standard salvage chemotherapy regimen for relapsed/refractory EGGCT patients. Autologous stem cell transplantation (ASCT) has increasingly been used in recent years as a second or third salvage therapy. In this study, we aimed to share our experience with the relapsed/refractory EGGCT patients who underwent ASCT. Methods: The data of patients who underwent ASCT and were followed up according to tango in EGGCT between 1991 and 2015 at the University of Health Sciences Turkey, Gulhane Training and Research Hospital, Ankara, Turkey, were retrospectively analyzed. Results: This study included 30 patients. The most common involvement site was the retroperitoneum (n=20, 66.7%), followed by the mediastinum (n=10, 33.3%). Retroperitoneal lymph node dissection was performed in 14 patients. Due to relapse, 27 patients received 3 cycles of TIP (paclitaxel, ifosfamide and cisplatin) and three patients received 3 cycles of VIP (etoposide, ifosfamide and cisplatin) treatment as the first salvage. Complete response was achieved in 10 patients. Progression was recorded in five patients. As the second salvage, 13 patients received VIP and three patients received TIP. In addition, 10 patients underwent ASCT as the second salvage and 20 patients had the third salvage. Nine patients died and 21 patients were still under follow-up. Conclusions: Although the chemosensitivity and prognosis are worse in patients with EGGCT than in those with gonadal GCT, their survival seems to be increased significantly with multimodal treatments and ASCT.