Survival analysis of children with stage II testicular malignant germ cell tumors treated with surgery or surgery combined with adjuvant chemotherapy

• Published in: Ai zheng 2015-02, Vol.34 (2), p.86-93
• Main Authors: Lu, Su‐Ying, Sun, Xiao‐Fei, Zhen, Zi‐Jun, Qin, Zi‐Ke, Liu, Zhuo‐Wei, Zhu, Jia, Wang, Juan, Sun, Fei‐Fei
• Format: Article
• Language: English
• Subjects: Adolescent; Chemotherapy, Adjuvant; Child; Child, Preschool; Combined Modality Therapy; Germ cell tumors; Humans; Infant; Male; Neoplasm Staging; Neoplasms, Germ Cell and Embryonal - mortality; Neoplasms, Germ Cell and Embryonal - pathology; Neoplasms, Germ Cell and Embryonal - therapy; Original; stage II; Survival Rate; testicular cancer; Testicular Neoplasms - mortality; Testicular Neoplasms - pathology; Testicular Neoplasms - therapy; 儿童; 化疗; 恶性; 手术治疗; 生存分析; 生殖细胞; 睾丸; 肿瘤标记物
• ISSN: 1000-467X; 2523-3548; 1944-446X; 2523-3548
• DOI: 10.5732/cjc.014.10027

For children with stage II testicular malignant germ cell tumors （MGCT）, the survival is good with surgery and adjuvant chemotherapy. However, there is limited data on surgical results for cases in which there was no imaging or pathologic evidence of residual tumor, but in which serum tumor markers either increased or failed to normalize after an appropriate period of half-life time post-surgery. To determine the use of chemotherapy for children with stage II germ cel tumors, we analyzed the outcomes （relapse rate and overall survival） of patients who were treated at the Sun Yat-sen University Cancer Center between January 1990 and May 2013. Twenty-four pediatric patients with a median age of 20 months （range, 4 months to 17 years） were enrol ed in this study. In 20 cases （83.3%）, the tumors had yolk sac histology. For definitive treatment, 21 patients underwent surgery alone, and 3 patients received surgery and adjuvant chemotherapy. No relapse was observed in the 3 patients who received adjuvant chemotherapy, whereas relapse occurred in 16 of the 21 patients （76.2%） treated with surgery alone. There were a total of 2 deaths. Treatment was stopped for 1 patient, who died 3 months later due to the tumor. The other patient achieved complete response after salvage treatment, but developed lung and pelvic metastases 7 months later and died of the tumor after stopping treatment. For children treated with surgery alone and surgery combined with adjuvant chemotherapy, the 3-year event-free survival rates were 23.8% and 100%, respectively （P=0.042）, and the 3-year overal survival rates were 90.5%and 100%, respectively （P=0.588）. These results suggest that adjuvant chemotherapy can help to reduce the recurrence rate and increase the survival rate for patients with stage II germ cel tumors.