CNS Germ Cell Tumours

C71WHO Vol. 6 (CNS5, 2021)

Central Nervous System (CNS)

Prognosis

This section is being prepared by our editorial process.

🔬 Histological Types

📚 Latest Research

2026-09-07

Reduced-dose Radiotherapy without Chemotherapy for Intracranial Germinomas: Results from an Asian Multicenter Study.

Wee CW, et al

A large Asian multicenter retrospective study of 139 patients with intracranial pure germinoma demonstrates that reduced-dose radiotherapy (rdRT) alone — without chemotherapy — achieves excellent long-term disease control, with 5-year and 10-year event-free survival (EFS) rates of 90.0% and 88.4%, respectively, and an overall survival of 100.0% at 5 years and 98.4% at 10 years after a median follow-up of 102 months. Tumor doses of 30.6 Gy and extended-field doses of 18 Gy proved adequate, as escalation beyond 30.6 Gy did not improve EFS (P = 1.000), and a whole-ventricle dose of 18 Gy was not inferior to higher doses (P = 0.155). Notably, patients with bifocal disease (suprasellar and pineal, n = 24) benefited significantly from craniospinal irradiation, achieving a 5-year EFS of 100.0% versus 63.3% without it (P = 0.040), and no grade ≥3 acute or late toxicities or secondary malignancies were observed across the cohort.

Neuro-oncology

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2026-08-25

Epidemiology and long-term survival of primary central nervous system germ cell tumors in Korea: a nationwide population-based study, 2005-2022.

Byun YH, et al

A nationwide population-based study of 1,642 newly diagnosed primary CNS germ cell tumors (CNSGCTs) in Korea from 2005 to 2022 found that the incidence was significantly higher in Korea than in the United States, with the highest rates observed in adolescents aged 10–19 years and a marked male predominance. Long-term survival outcomes were excellent, with 1-, 5-, 10-, and 15-year relative survival rates of 95.4%, 89.6%, 87.1%, and 84.6%, respectively, comparable to outcomes reported from the US and Japan. Germinoma was the most common histopathologic subtype and carried the most favorable prognosis, while distinct survival differences were observed across age groups and tumor subtypes. These findings provide the most comprehensive long-term epidemiologic data on CNSGCTs in Korea to date and highlight the importance of histologic subtype and age in guiding prognosis.

Neuroepidemiology

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2026-08-17

Suprasellar germinoma: intraoperative findings from an endoscopic endonasal approach. Illustrative case.

Ichikawa-Escamilla E, et al

A 25-year-old patient with a suprasellar mass initially suspected to be a craniopharyngioma was found intraoperatively to harbour a germinoma, prompting the surgical team to abandon planned resection and perform a biopsy instead. Postoperative chemoradiotherapy produced a complete radiological response confirmed on follow-up MRI, along with improvement of clinical symptoms. This illustrative case establishes three actionable teaching points for clinicians: arginine vasopressin deficiency and anterior pituitary dysfunction in a young patient with a suprasellar mass should raise suspicion for germinoma; glucocorticoid replacement can unmask arginine vasopressin deficiency by reversing cortisol deficiency-mediated antidiuresis; and surgeons performing endoscopic endonasal procedures must be prepared to make real-time operative decisions based on intraoperative findings.

Journal of neurosurgery. Case lessons

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