Treatment results of childhood extracranial malignant germ cell tumors and the salvage approach for recurrent and refractory cases: a single-center report

Abstract

Abstract 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 second-line 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.