• Yi Zhang, Huijuan Zhu, Kan Deng, Wenbin Ma, Yu Wang, Jian Sun, Xin Lian, Hui Pan, Renzhi Wang, and Yong Yao.
• Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China.
• World Neurosurg. 2018 Apr 1; 112: e229-e239.

BackgroundThe biopsy is recognized as the most accurate method to determine the histologic characterization of sellar germ cell tumors. It is difficult to evaluate the prognosis before histologic confirmation.ObjectiveThis study aimed to evaluate the independent prognostic risk factors of patients with sellar germ cell tumors (GCTs).MethodsFrom January 2008 to December 2015, 61 patients who were histologically diagnosed as having sellar GCTs were followed up and were included in this retrospective study.ResultsOf 61 patients in this study, 40 (65.6%), 10 (16.4%), and 11 (18.0%) were diagnosed as having pure germinomas, germinomas with syncytiotrophoblastic giant cells and non-germinomatous GCTs (NGGCTs), respectively. The patients with pure germinomas had a significantly better overall survival time than did those with NGGCT (56.47 ± 3.01 months vs. 43.09 ± 10.58 months; P = 0.01). Multivariate analysis showed that the independent poor prognostic risk factors of patients with sellar GCTs were diameters >15 mm (odds ratio [OR], 7.40; 95% confidence interval [CI], 2.01-27.19), octamer-binding transcription positivity (OR, 5.97; 95% CI, 1.40-25.48), and NGGCT (OR, 11.88; 95% CI, 2.37-59.50), whereas the combination of chemotherapy and radiotherapy was associated with a better prognosis (OR, 0.15; 95% CI, 0.04-0.55).ConclusionsDiameter >15 mm, octamer-binding transcription positivity, or NGGCT was associated with a poorer prognosis for patients with sellar GCTs, whereas the combination of chemotherapy and radiotherapy was associated with a better prognosis.Copyright © 2018 Elsevier Inc. All rights reserved.

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