Surgical treatment confers prognostic significance in pediatric malignant mediastinal germ cell tumors

Abstract

Background: Primary malignant mediastinal germ cell tumors (GCTs) are rare pediatric tumors that have a poorer prognosis compared to GCTs occurring elsewhere in the body. The current study aimed to assess the prognostic factors and treatment outcomes of children with primary malignant mediastinal GCT in Taiwan. Methods:The authors retrospectively reviewed children 0-18 years old who were newly diagnosed with primary malignant mediastinal GCT between January 1, 2005 and December 31, 2019 and were registered in the Taiwan Pediatric Oncology Group patient registry. The impact of presenting characteristics, including sex, age,

Pediatric Extracranial Germ Cell Tumors: Review of Clinics and Perspectives in Application of Autologous Stem Cell Transplantation

“…CC is fragile and bleeds easily. Most patients have already developed metastases at diagnosis, and the prognosis is poor among pediatric GCTs [ 35 , 36 , 37 ].…”

“…Mixed GCTs are the second common histology type of malignant GCTs, accounting for around 40% [ 4 , 35 ]. Mixed malignant GCTs consist of more than two histology types of malignant germ cells and are more frequent with increasing age [ 23 ].…”

“…Given the rarity of pediatric GCTs, some subgroups of patients with poor prognosis may not be clearly distinguished by this stratification system, such as those with extragonadal GCTs, especially in the primary mediastinal region. Despite multi-modality treatment with chemotherapy and surgical treatment, the 5-year EFS and OS were 40% and 54%, respectively [ 35 ]. In addition, the treatment outcome of mediastinal choriocarcinoma was extremely poor.…”

“…In addition, the treatment outcome of mediastinal choriocarcinoma was extremely poor. None of the nine patients survived more than five years [ 35 ].…”

“…For example, the expected DFS for patients over 11 years of age with stage IV ovarian disease, stages II–III extragonadal disease, and stage IV extragonadal disease are 67%, 65%, and 40%, respectively [ 4 ]. In addition to the above patients, the 5-year OS of pediatric mediastinal GCTs is only 54%, especially in patients who have not undergone surgical resection; then, the OS is only 7% [ 35 ] ( Table 1 ). Pediatric CC or patients without a good response to treatment, such as when tumor markers decline as expected, have a poor prognosis.…”