Prognostic factors in children with extracranial malignant germ cell tumors: a monocentric pediatric Tunisian study

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Published Sep 6, 2016
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Vol. 94 No. 4 (2016): Issue Apr 2016

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Faten Fedhila
Samar Rhayem
Habiba Hafsi
Wiem Douira
Raoudha Doghri
Monia Khemiri
Karima Mrad
Ibtissem Bellagha
Bechir Zouari
Sihem Barsaoui

Abstract

ABSTRACT:
Background: Extracranial Germ cell tumors (GCT) are a rare and a heterogeneous group of pediatric cancers but highly curable.
Aim: We aimed to review management, outcome and prognostic factors that influence overall survival (OS) in a pediatric Tunisian oncologic unit.
Methods: We retrospectively evaluated between January 1998 and December 2012, 33 patients affected by extracranial germ cell tumors and treated according to TGM95 protocol established by the SFOPin a pediatric Tunisian oncologic unit.
Results: Patients had a mean age of 57 months (ranges: 1 day-13 years). There were 19 girls and 14 boys. Primary sites included 12 sacrococcygeal, 11 ovarian, 6 testicular, 3retro peritoneal and 1 mediastinal site. After a mean follow up of 26.1 months (ranges: 0-96 months), OSat 2 years and 5 years were respectively 82% and 75%. Event-free survival were respectively 79% at 2 years and 74% at 5 years. Various prognostic factors have been studied according to Kaplan-Meier. Univariate analyses identified significant factors which influence strongly OS: the stage (p=0.04), the completeness of surgery (p<0.001) and the relapse (p = 0, 0001). A multivariate study showed that only the quality of resection and the clinical stage remained strong significant prognostic factors (p=0,021) for 5-year OS.
Conclusion: Disease stage, completeness of surgery and relapse have been established as the most powerful prognostic parameter in our analysis. The improvement of survival of patients affected by extracranial germ cell tumors in Tunisia is a real achievement mainly due to the success of salvage treatments.

Keywords:

germ cell tumors; children; prognosis.

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