Mediastinal Nonseminomatous Germ Cell Tumors: Whereas treatment of mediastinal seminoma remains controversial, nearly all experienced investigators view chemotherapy as the principal mode of therapy in mediastinal nonseminomatous germ cell tumors. Most investigators recommend that, after histologic or serologic confirmation of the presence of a mediastinal nonseminomatous germ cell tumor, the patient receive modern cisplatin-based chemotherapy. If the patients serum tumor marker levels normalize, complete resection of persistent roentgenographic abnormalities by an experienced thoracic surgeon is crucial to remove residual teratoma, persistent cancer, or malignant nongerm cell elements. flovent inhaler
There is now broad recognition that mediastinal nonseminomatous germ cell tumors carry a poor prognosis relative to their testicular counterparts, and as such, should be entered on clinical trials with more intensive regimens or with the addition of newer agents. Despite this relatively poor prognosis, there is evidence that therapeutic outcome is improving with modern treatment. A recent review at Indiana University included 31 patients with mediastinal nonseminomatous germ cell tumors treated with an integrated program of cisplatin-based chemotherapy followed by surgery if required. Among this group of patients, 18 patients (58 percent) attained a disease free status and 13 patients (42 percent) were partial responders.
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