|Kejun He,Zhen Tan,Xiaojun Yuan. Treatment results of childhood extracranial malignant germ cell tumors and the salvage approach for recurrent and refractory cases: a single-center report. Oncol Transl Med, 2019, 5: 229-236.
|Treatment results of childhood extracranial malignant germ cell tumors and the salvage approach for recurrent and refractory cases: a single-center report
|Received:May 29, 2019 Revised:November 21, 2019
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|KeyWord:chemotherapy; germ cell tumor; radiotherapy; surgery; children
|Kejun He ||Department of Pediatric Hematology/Oncology, Xinhua Hospital AffiliatedBeginEttoEndETShanghai Jiao Tong University School of Medicine, Shanghai 200092, China ||Department of Pediatric Hematology/Oncology|
|Zhen Tan ||Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine ||Department of Pediatric Hematology/Oncology|
|Xiaojun Yuan ||Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine ||Department of Pediatric Hematology/Oncology|
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| Objective The aim of this study is to report the treatment result of childhood excranial malignant germ cell
tumors and discuss the experience for recurrent and refractory cases treatment from our center.
Methods We have retrospectively analyzed 58 extracranial malignant germ cell tumor patients treated with
surgery and chemotherapy from our center over a 9-year period. Another 14 recurrent and refractory cases
referred from other centers were added to the study for salvage approach. We evaluated the treatment
results for primary cases and relapsed cases with a median follow-up of 61.5 months. Several factors were
analysed to evaluate their power to the outcome of these cases.
Results The 5-year event-free and overall survival for primary cases were 74.1±5.7% and 86.2±4.5%,
respectively. 25 recurrent or refractory cases entered the salvage approach study, and 17 patients were
alive till the end of follow-up. We demonstrated superior survival outcome for those with successful local
control through pre-operative and post-operative radiotherapy, second-look surgery and multi-drug secondline chemotherapies.
Conclusion The outcome for childhood extracranial malignant germ cell tumors is generally favorable.
For recurrent and refractory cases, multi-modality treatment approaches including radiotherapy, salvage
chemotherapy and secondlook surgery are important for better local control.