The outcomes of pediatric extracranial malignant germ cell tumors: A decade of experience from a single institution in Southern Vietnam

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer Pub Date : 2025-03-06 DOI:10.1016/j.currproblcancer.2025.101197

An Thi Thanh Dao , Nhi Thuy To , Chau Hoan Nguyen , Khai Dinh Truong , Tuan Diep Tran , Soh Shui Yen , Amos Loh Hong Pheng , Michelle Hermiston , Phi Duong Nguyen

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引用次数: 0

Abstract

Background

Extracranial malignant germ cell tumors (GCTs) generally exhibit favorable outcomes with contemporary therapeutic approaches. However, the outcomes of pediatric GCTs in Vietnam remain unclear. This study aims to evaluate the clinical features, treatment modalities, and prognostic factors associated with survival outcomes in children with GCTs treated at Children's Hospital Number 2 (CH2) in Ho Chi Minh City, Vietnam.

Methods

We conducted a retrospective cohort study involving pediatric patients with GCTs treated at CH2 between January 1, 2011, and July 30, 2019. Data were extracted from medical records and entered into REDCap for analysis using SPSS version 20.0 (IBM Corporation, Armonk, NY). Descriptive statistics were reported as mean ± standard deviation, unless otherwise specified. Overall survival (OS) and event-free survival (EFS) rates were estimated using the Kaplan-Meier method, and the log-rank test was employed to assess the significance of potential prognostic factors.

Results

A total of 69 patients with a median age of 25 months were included in the study. Of these, 48 (69.9 %) had gonadal tumors, and 21 (30.4 %) had extragonadal tumors. The median alpha-fetoprotein (AFP) level at diagnosis was 2,589 kU/L, with 26 (37.7 %) patients presenting with AFP levels exceeding 10,000 kU/L. All patients underwent surgical resection followed by platinum-based chemotherapy (carboplatin in 92.8 % and cisplatin in 7.2 %). The incidence of grade 3-4 toxicities (neutropenia, febrile neutropenia, and thrombocytopenia) varied between 3.5 % and 19.4 % per chemotherapy cycle. The mean follow-up duration was 53.3 months, with a relapse rate of 5.8 % and an abandonment rate of 11.6 %. The 5-year OS and EFS rates were 92.5 % and 91 %, respectively. EFS was significantly higher in patients with gonadal tumors compared to those with extragonadal tumors (95.7 % vs 84.4 %, p = 0.035). Additionally, OS was significantly better in patients with stage I-II tumors compared to those with stage III-IV (100 % vs 86.2 %, p = 0.03), in patients with AFP levels <10,000 kU/L compared to those with AFP >10,000 kU/L (97.6 % vs 84 %, p = 0.041), and in patients who did not abandon treatment (94.9 % vs 77 %, p = 0.044).

Conclusions

The outcomes of pediatric extracranial malignant germ cell tumors in this cohort were excellent, with relatively low early treatment-related toxicity. Reducing treatment abandonment and identifying high-risk patients for intensified therapy may further improve survival outcomes in this setting.

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儿童颅内外恶性生殖细胞肿瘤的预后：越南南部一家机构的十年经验。

背景：颅外恶性生殖细胞瘤（gct）在现代治疗方法中通常表现出良好的预后。然而，越南儿童gct的结果仍不清楚。本研究旨在评估在越南胡志明市第二儿童医院（CH2）治疗的gct儿童的临床特征、治疗方式和与生存结果相关的预后因素。方法：我们对2011年1月1日至2019年7月30日期间在CH2接受gct治疗的儿科患者进行了一项回顾性队列研究。从医疗记录中提取数据，并输入REDCap，使用SPSS 20.0版（IBM Corporation, Armonk， NY）进行分析。除非另有说明，描述性统计以平均值±标准差报告。采用Kaplan-Meier法估计总生存率（OS）和无事件生存率（EFS），并采用log-rank检验评估潜在预后因素的重要性。结果：共有69例患者纳入研究，中位年龄为25个月。其中48例（69.9%）为性腺肿瘤，21例（30.4%）为角外肿瘤。诊断时甲胎蛋白（AFP）水平中位数为2589 kU/L， 26例（37.7%）患者AFP水平超过10,000 kU/L。所有患者均行手术切除，随后行铂类化疗（卡铂占92.8%，顺铂占7.2%）。3-4级毒性（中性粒细胞减少症、发热性中性粒细胞减少症和血小板减少症）的发生率在每个化疗周期的3.5%至19.4%之间变化。平均随访53.3个月，复发率5.8%，放弃率11.6%。5年OS和EFS分别为92.5%和91%。性腺肿瘤患者的EFS明显高于角外肿瘤患者（95.7% vs 84.4%, p = 0.035）。此外，I-II期肿瘤患者的OS明显优于III-IV期肿瘤患者（100% vs 86.2%, p = 0.03）， AFP水平为10,000 kU/L的患者（97.6% vs 84%, p = 0.041），以及未放弃治疗的患者（94.9% vs 77%, p = 0.044）。结论：该队列中儿童颅外恶性生殖细胞肿瘤的预后良好，早期治疗相关毒性相对较低。在这种情况下，减少放弃治疗和确定高危患者进行强化治疗可能会进一步改善生存结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Cancer 医学-肿瘤学

CiteScore

5.10

自引率

0.00%

发文量

审稿时长

15 days

期刊介绍： Current Problems in Cancer seeks to promote and disseminate innovative, transformative, and impactful data on patient-oriented cancer research and clinical care. Specifically, the journal''s scope is focused on reporting the results of well-designed cancer studies that influence/alter practice or identify new directions in clinical cancer research. These studies can include novel therapeutic approaches, new strategies for early diagnosis, cancer clinical trials, and supportive care, among others. Papers that focus solely on laboratory-based or basic science research are discouraged. The journal''s format also allows, on occasion, for a multi-faceted overview of a single topic via a curated selection of review articles, while also offering articles that present dynamic material that influences the oncology field.