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Clinical Characteristics and Outcome of Infantile Extracranial Germ Cell Tumors: A Multi-center 10-year Retrospective Study
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  • Zhaoxia Zhang,
  • Shuai Zhu,
  • Tian Zhi,
  • Qing Sun,
  • Weihong Zhao,
  • Dongsheng Huang,
  • Xiaoli Ma,
  • Rong Liu
Zhaoxia Zhang
Capital Institute of Pediatrics
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Shuai Zhu
Beijing Children’s Hospital, Capital Medical University,National Center for Children’s Health
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Tian Zhi
Beijing Tongren Hospital
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Qing Sun
Peking University First Hospital
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Weihong Zhao
Peking University First Hospital
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Dongsheng Huang
Beijing Tongren Hospital
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Xiaoli Ma
Beijing Children's Hospital
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Rong Liu
Capital Institute of Pediatrics

Corresponding Author:liurong201305@sina.com

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Abstract

Objectives: To summarize the clinical characteristics and outcome of infantile extracranial germ cell tumors(GCTs) from four different centers in China since the last 10 years. Methods: Fifteen cases of infantile extracranial GCTs diagnosed between January 1st, 2010 to December 31st, 2019 were evaluated. Results: Nine patients were males(60%) and six were females(40%). The median age was 5.2 months(ranges:2.4-11.8months). There were six cases(40%) in retroperitoneum, six cases(40%) in sacrococcygeal, one case(6.6%) in testicular, one case(6.6%) in hip and one case(6.6%) in mediastinum. Histologically, there were 10 cases(66.6%) of immature teratoma, 3(20%) mixed GCTs and 2(13.3%) malignant GCTs. One case was stageII(6.6%), eleven stageIII(73.3%), one stageIV(6.6%) and two cases were unclear(13.3%). Nine cases(60%) had alpha-fetoprotein(AFP) level of higher than 1000ng/ml. All of the cases received adjuvant chemotherapy in which platinum-based chemotherapy regimens were mostly used. The median follow-up time was 31 months(range: 3–81 months). At the end of treatment, 12 patients got CR(80%), 1 PR(6.7%) and 2 NR(13.3%). During the follow-up period, 12 patients alive without disease and 3 patient who did not got CR at the end of treatment died of disease progression. Conclusions: Most of infantile extracranial GCTs located outside the gonads. Sacrococcygeal and retroperitoneal regions were common sites. Histologically, teratoma was more common in infantile GCTs. Early diagnosis is needed and chemotherapy regimen needs to be further standardized in China. An evaluation system is needed to figure out treatment efficacy and prognosis in the future.