Evidence map›Paper›PMID 39492661›Full record

Trial reportNeuro-oncology2025

Phase II trial of pathology-based tripartite treatment stratification for patients with CNS germ cell tumors: A long-term follow-up study.

Hirokazu Takami, Masao Matsutani, Tomonari Suzuki, Kazuhiko Takabatake, Takamitsu Fujimaki, Michinari Okamoto, Shigeru Yamaguchi, Masayuki Kanamori, Kenichiro Matsuda, Yukihiko Sonoda and 30 more

Abstract readClinical Trial, Phase II
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Metachronous Pineal Germinoma 11 Years After Total Resection of a Mature Teratoma.Neuropathology : official journal of the Japanese Society of Neuropathology · 2026
    Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

40 authors.

Hirokazu TakamiDepartment of Neurosurgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan (H.Takami, S.T., N.Saito).ORCID 0000-0001-9742-7462
Masao MatsutaniDepartment of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan (M.M., T.S., R.N.).
Tomonari SuzukiDepartment of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan (M.M., T.S., R.N.).
Kazuhiko TakabatakeDepartment of Neurosurgery, Saitama Medical University Hospital, Saitama, Japan (K.T., T.F.).
Takamitsu FujimakiDepartment of Neurosurgery, Saitama Medical University Hospital, Saitama, Japan (K.T., T.F.).
Michinari OkamotoDepartment of Neurosurgery, Hokkaido University School of Medicine, Hokkaido, Japan (M.O., S.Yamaguchi).
Shigeru YamaguchiDepartment of Neurosurgery, Hokkaido University School of Medicine, Hokkaido, Japan (M.O., S.Yamaguchi).
Masayuki KanamoriDepartment of Neurosurgery, Tohoku University Graduate School of Medicine, Miyagi, Japan (M.K.).ORCID 0000-0002-3380-1192
Kenichiro MatsudaDepartment of Neurosurgery, Faculty of Medicine, Yamagata University, Yamagata, Japan (K.Matsuda, Y.S.).
Yukihiko SonodaDepartment of Neurosurgery, Faculty of Medicine, Yamagata University, Yamagata, Japan (K.Matsuda, Y.S.).
Manabu NatsumedaDepartment of Neurosurgery, Niigata University, Niigata, Japan (M.Natsumeda).
Toshiya IchinoseDepartment of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan (T.I., M.Nakada).
Mitsutoshi NakadaDepartment of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan (T.I., M.Nakada).
Ai MuroiDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan (A.Muroi, E.I.).
Eiichi IshikawaDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan (A.Muroi, E.I.).
Masamichi TakahashiDepartment of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan (M.T., Y.N.).
Yoshitaka NaritaDepartment of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan (M.T., Y.N.).ORCID 0000-0003-4303-6006
Shota TanakaDepartment of Neurosurgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan (H.Takami, S.T., N.Saito).
Nobuhito SaitoDepartment of Neurosurgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan (H.Takami, S.T., N.Saito).
Fumi HiguchiDepartment of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan (F.H., M.S.).
Masahiro ShinDepartment of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan (F.H., M.S.).
Yohei MineharuDepartment of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan (Y.M., Y.A.).
Yoshiki ArakawaDepartment of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan (Y.M., Y.A.).ORCID 0000-0003-4626-4645
Naoki KagawaDepartment of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan (N.K.).
Shinji KawabataDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan (S.K., M.W.).
Masahiko WanibuchiDepartment of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan (S.K., M.W.).
Takeshi TakayasuDepartment of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan (T.T., F.Y.).
Fumiyuki YamasakiDepartment of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan (T.T., F.Y.).ORCID 0000-0003-0164-6295
Kentaro FujiiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Okayama, Japan (K.F., J.I., I.D.).
Joji IshidaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Okayama, Japan (K.F., J.I., I.D.).
Isao DateDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Okayama, Japan (K.F., J.I., I.D.).
Keisuke MiyakeDepartment of Neurological Surgery, Kagawa University, Kagawa, Japan (K.Miyake).
Yutaka FujiokaDepartment of Neurosurgery, Kyushu University, Fukuoka, Japan (Y.F., D.K.).
Daisuke KugaDepartment of Neurosurgery, Kyushu University, Fukuoka, Japan (Y.F., D.K.).
Shinji YamashitaDepartment of Neurosurgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan (S.Yamashita, H.Takeshima).
Hideo TakeshimaDepartment of Neurosurgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan (S.Yamashita, H.Takeshima).
Naoki ShinojimaDepartment of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (N.Shinojima, A.Mukasa).
Akitake MukasaDepartment of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan (N.Shinojima, A.Mukasa).
Akio AsaiDepartment of Neurosurgery, Kansai Medical University Hospital, Osaka, Japan (A.A.).
Ryo NishikawaDepartment of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan (M.M., T.S., R.N.).ORCID 0000-0001-5617-8068

Funding

Japan Society for the Promotion of Science 22K16650 and 24K12236
6 · The paper itself

Abstract

backgroundA previous Phase II clinical trial, conducted from 1995 to 2003, evaluated CNS germ cell tumors (GCTs) using a three-group treatment stratification based on histopathology. The primary objective of the study was to assess the long-term efficacy of standardized treatment regimens, while the secondary objective focused on identifying associated long-term complications.

methodsA total of 228 patients were classified into 3 groups for treatment: germinoma (n = 161), intermediate prognosis (n = 38), and poor prognosis (n = 28), excluding one mature teratoma case. Treatment involved stratified chemotherapy regimens and varied radiation doses/coverage. Clinical data was retrospectively analyzed at a median follow-up of 18.5 years.

resultsThe treatment outcomes for germinoma, with or without syncytiotrophoblastic giant cells, were similar. The 10- and 20-year event-free survival rates for the germinoma, intermediate, and poor prognosis groups were 82/76/49% and 73/66/49%, respectively. Overall survival (OS) rates were 97/87/61% at 10 years and 92/70/53% at 20 years. Germinomas in the basal ganglia, treated without whole-brain radiation therapy (WBRT), frequently relapsed but were effectively managed with subsequent WBRT. Deaths in germinoma cases had varied causes, whereas deaths in the poor prognosis group were predominantly disease-related. Nineteen treatment-related complications were identified in 16 patients, with cumulative event rates of 1.9% at 10 years and 11.3% at 20 years. OS rates at 1 and 2 years post-relapse for tumors initially classified as germinoma, intermediate, and poor prognosis were 94/88/18% and 91/50/9%, respectively.

conclusionsInitial treatment intensity is crucial for managing non-germinomatous GCTs, while long-term follow-up for relapse and complications is imperative in germinomas. Irradiation extending beyond the immediate tumor site is essential for basal ganglia germinomas. Addressing relapse in non-germinomatous GCT remains a significant challenge.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCentral Nervous System NeoplasmsNeoplasm Recurrence, LocalNeoplasms, Germ Cell and EmbryonalAdolescentAdultChildChild, PreschoolFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival Rategerm cell tumorgerminomanon-germinomatousprognosissecondary malignancy

Identifiers

PMID39492661
PMCPMC11889720

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.