Primary mediastinal seminoma

Aleksandra Napieralska, Wojciech Majewski, Wojciech Osewski, Leszek Miszczyk


Background: The objective of this study was to evaluate the long term treatment results of patients with primary mediastinal seminoma.
Methods: Sixteen patients aged 21–46 diagnosed with primary mediastinal seminoma between 1983 and 2014. Mean size of the tumor was 65 cm2. In all patients gonadal involvement was excluded. In 6 patients, metastases to regional lymph nodes were found and none of them presented with distant metastases. HCG was elevated in 6 patients (38%). Eight patients underwent surgery as first-line of the treatment: 7 partial and 1 complete resection of the tumor. Chemotherapy (CTH) and radiotherapy (RTH) were methods of treatment in 14 cases. Tumor was irradiated to total dose of 36.0–50.4 (median 42.5) Gy. In statistical analysis overall survival (OS) was calculated using Kaplan-Meier method.
Results: During median time of 11 years of the follow-up, complete or partial regression (PR) of the tumor was seen in all patients after primary treatment. Recurrence of the tumor was seen in 3 patients. The 5-, 10- and 15-year local control rates were 75%. One was treated with CTH, other two with RTH. All of them responded with complete regression (CR) of the tumor. Three patients died during the follow-up. All others are alive without disease. The 5-, 10- and 15-year OS was 100%, 91% and 91% respectively.
Conclusions: Chemoradiotherapy of primary mediastinal seminoma gives satisfactory treatment results with good local control rate. The treatment outcome is comparable to primary testicular seminoma.