A retrospective single-center study of treatment experience of recurrent extracranial malignant germ cell tumor in 19 children
10.3760/cma.j.cn101070-20230407-00275
- VernacularTitle:单中心19例复发性颅外恶性生殖细胞肿瘤挽救性治疗经验及回顾性分析
- Author:
Yali HAN
1
;
Jingyan TANG
;
Ci PAN
;
Anan ZHANG
;
Meng SU
;
Dapeng JIANG
;
Yumin ZHONG
;
Minzhi YIN
;
Yijin GAO
Author Information
1. 上海交通大学医学院附属上海儿童医学中心血液肿瘤科，上海 200127
- Keywords:
Child;
Extracranial;
Malignant germ cell tumor, recurrent
- From:
Chinese Journal of Applied Clinical Pediatrics
2024;39(2):109-113
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the survival and prognostic factors for the recurrent extracranial malignant germ cell tumors (MGCTs) in children, and to explore feasible salvage treatment.Methods:A retrospective study.Pediatric patients with recurrent extracranial MGCTs diagnosed in Shanghai Children′s Medical Center between January 2010 and January 2020 were retrospectively recruited.Comprehensive treatment regimens included surgery, chemotherapy and radiation.Kaplan-Meier survival analysis and Cox regression model were employed to analyze the survival and prognostic factors for children with recurrent extracranial MGCTs.Results:A total of 172 children with extracranial MGCTs were treated, including 21 (12.2%) recurrent cases.The median time of MGCT recurrence after the end of the first treatment was 11 months.Finally, 19 patients were recruited after excluding 2 non-eligible cases, including 10 boys and 9 girls with the age at recurrence of 26 (8-170) months.The follow-up time was 57 (13-122) months.Salvage chemotherapy, complete resection and radiotherapy were performed in 16, 14 and 4 patients, respectively.The 4-year overall survival (4yr-OS) rate was (82.5±9.2)%(19 cases). The 4yr-OS rate was significantly higher in patients managed with surgery but without adjuvant chemotherapy at the initial treatment (13 cases) than those managed with chemotherapy at the initial treatment (6 cases)[(92.3±7.4)% vs.(60.0%±21.9)%, P=0.002]. Univariant and Cox multivariant regression analyses showed that failure to achieve the normal range of alpha fetoprotein after 3 cycles of chemotherapy significantly influenced the survival of recurrent extracranial MGCTs. Conclusions:For patients with recurrent extracranial MGCTs, comprehensive treatment approaches like complete surgical resection, chemotherapy, and radiotherapy offer a favorable survival rate.Specifically, recurrent and re-treated patients who initially received surgery alone without adjuvant chemotherapy have a higher survival rate compared to those who received chemotherapy during the initial treatment.
