Abstract Date: 5/1/2016
Hirokazu Takami, MD
Shintaro Fukushima, MD, PhD
Kohei Fukuoka, MD
Yoshitaka Narita, MD, PhD
Ryo Nishikawa, MD, PhD
Masao Matsutani, MD, PhD
Koichi Ichimura, MD, PhD (Tokyo, Japan)
The Intracranial Germ Cell Tumor Genome Analysis (iGCT) Consortium was established in 2011 to facilitate investigation into the biology and their clinical association in central nervous system germ cell tumors (CNS GCT). Here we present an integrated analysis on the clinical characteristics in relation to genomic data.
A total of 132 cases (male 117, female 15) were selected for the study. The median age was 16 y.o. in male and 20 y.o. in female. A central pathological review determined 73 pure germinoma, 23 mixed germinoma, 30 non-germinomatous GCT (NGGCT) and 6 others.
Eight cases were under 5 years old, and all had teratoma component except one (YST).Five/ten-year progression-free survival of pure germinoma, mixed germinoma and NGGCTs were 81.0/66.9, 67.5/60.8, and 82.6/64.3 %, respectively; 5/10-year overall survival being 86.4/78.4, 70.3/57.1, and 82.9/66.9 %. Germinoma cases which occurred in neurohypophyseal or pineal regions had significantly longer PFS compared with those outside such predilection areas (p=0.004). Mixed germinoma which harbor a choriocarcinoma component had a significant tendency to occur outside neurohypophyseal or pineal regions (p=0.005). Cases which had an immature teratoma component were significantly younger than those without (p=0.007). No female case (n=14) had MAPK pathway mutations, contrasted by a high mutation rate (51.3 %) in male.
Serum or CSF hormonal values were available in 120 cases. Elevated AFP was seen in 28 cases and many (8) had a YST component; however mature and immature teratoma cases were also included in 5 cases each. For HCG elevation, 11 cases were found, and one cases of pure germinoma was included. These suggest that elevated hormonal values cannot necessarily lead to the diagnosis of malignant GCTs and has the possibility of pure germinoma or mature teratoma.
It is imperative to further the integrated analyses of clinical and genomic data in order to clarify the treatment targets.
Article ID: AA-35064