Long-term outcomes and late complications of intracranial germinoma: implications for follow-up policy

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ID: 314594
2026
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Abstract
Abstract Background We retrospectively assessed the long-term efficacy, safety and functional outcome of chemotherapy and radiotherapy (RT) in patients with intracranial germinoma (iGE). Methods A total of 160 patients with iGE treated between 1983 and 2013 were reviewed. Overall survival (OS) was estimated using Kaplan-Meier method. The cumulative incidence of recurrence (CIR), and secondary malignancies (CISM) were analyzed using cumulative incidence functions (CIFs), with death without the event of interest treated as a competing risk. Functional outcomes were assessed using the Karnofsky Performance Scale (KPS). Cox proportional hazards regression was used to analyze predictive factors. Results The mean follow-up duration was 157.1 months. The 5-/10-year OS rates were 93.8% and 88.6%. The 5- and 10- year CIR were both 5.6%, whereas the CISM were 0.6% and 2.1% respectively. Secondary malignancies developed in 14 patients, most commonly glioblastoma. Thirty-one patients died from disease-, treatment-, or secondary malignancy-related causes. Additional causes of death were identified during long-term follow-up, even more than 20 years after treatment. Functional outcomes remained favorable (KPS ≥ 60) in 90.6% at 5 years and 88.5% at 10 years. Chemotherapy combined with reduced extent and reduced-dose RT significantly improved OS without increasing the CIR. Conclusions Despite the generally favorable prognosis, secondary malignancies and disease- and treatment-related long-term adverse effects significantly affect patient outcomes in iGE. Long-term follow-up (over 20 years) is essential for detecting and managing these complications. Chemotherapy with reduced-extent and reduced-dose RT may help minimize long-term adverse effects.
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Authors Y M Shim, Seung-Ki Kim, Kyung Hyun Kim, Kyung Taek Hong, Chae‐Yong Kim, C Park, Ji Yeoun Lee, Ji Hoon Phi, Hee Young Shin, Hyo Seop Ahn, Byung-Kyu Cho, Il Han Kim, Kyu-Chang Wang
Journal Neuro-Oncology Advances
Year 2026
DOI
10.1093/noajnl/vdag135
URL
https://doi.org/10.1093/noajnl/vdag135
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