Treatment of pediatric extracranial germ cell tumors: Outcomes and related factors

Authors

  • Kamolchanok Nitipornsri Department of Pediatric, Maharat Nakhon Ratchasima Hospital
  • Angkana Winaichatsak Department of Pediatric, Maharat Nakhon Ratchasima Hospital

Keywords:

Treatment outcomes of germ cell tumors, survival rate, overall survival, event-free survival

Abstract

Background: Extracranial germ cell tumors are rare, accounting for approximately 3% of childhood cancers, but they are clinically significant due to their potential to cause life-threatening complications or adversely affect growth and development. Germ cell tumors exhibit diverse clinical characteristics, and chemotherapy regimens have continuously evolved. However, treatment outcomes have not yet been comprehensively evaluated, and no institutional data have been systematically collected to date

Objective:  To evaluate the clinical characteristics and treatment outcomes of extracranial germ cell tumors

Method: A retrospective study was conducted on patients aged 15 years old or younger who were diagnosed with extracranial germ cell tumors. Clinical characteristics, treatment outcomes, and survival rates were analyzed, and statistical comparisons were made using the log-rank test.

Results: Among 37 eligible patients, the median age at diagnosis was 3.3 years, with a female comprising 54.1% and male 45.9%. Most patients were diagnosed with extragonadal tumors (70.3%), primarily located in the mediastinum (29.7%), followed by retroperitoneum and sacrococcygeal area. Yolk sac tumors represented the most prevalent histological type (32.4%). The 5-year overall survival rate (OS) and event-free survival rate (EFS) were 68.5% and 62.0%, respectively. Survival analysis was performed using the log-rank test, with a          p value < 0.05 considered statistically significant. Patients aged over 10 years had lower overall survival (OS) than those aged under 5 years and 5-10 years (p value < 0.001), possibly due to the tendency of more aggressive tumor types in older children. In addition, patients with gonadal tumors had significantly better overall survival (OS) compared to those with extragonadal tumors (p value 0.022).

Conclusion: Extracranial germ cell tumors demonstrated favorable survival rates. However, patients aged over 10 years and those with extragonadal tumors were associated with a worse prognosis.

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References

Kaatsch P, Hafner C, Calaminus G, Blettner M, Tulla M. Pediatric germ cell tumors from 1987 to 2011: Incidence rates, time trends, and survival. Pediatrics. 2015;135:e136-43.

Murray MJ, Nicholson JC. Germ cell tumours in children and adolescents. Paediatr Child Health. 2010;20:109–16.

วรวุฒิ เชยประเสริฐ. โรคมะเร็งในเด็กที่พบบ่อย: ความรู้พื้นฐาน การวินิจฉัย และการรักษา Common Childhood Malignancies. พิมพ์ครั้งที่ 1. บริษัท ภาพพิมพ์ จำกัด; พ.ศ.2560. หน้า 197-207.

สมาคมโลหิตวิทยาแห่งประเทศไทย. แนวทางการรักษาโรคมะเร็งในเด็ก พ.ศ.2557 National protocol for the treatment of childhood cancers 2014. พิมพ์ครั้งที่ 1. กรุงเทพมหานคร: เอ็มพริ้นต์ คอร์ปอเรชั่น; พ.ศ.2557. หน้า 293-8.

Laohverapanich K, Buaboonnam J, Vathana N, Sanpakit K, Takpradit C, Narkbunnum N, et al. Clinical outcomes of extracranial germ cell tumors: A single institute’s experience. Siriraj Med J. 2021;73:680-6.

Ramanathan S, Prasad M, Vora T, Parambil B, Kembhavi S, Ramadwar M, et al. Promising outcomes of extracranial germ cell tumors in children & adolescents: Lessons learnt over a decade [Internet]. Authorea..2020.Oct.[cited.2025.Jun.24]..Available.from:.https://www.authorea.com/users/363956/articles/484563-promising-outcomes-of-extracranial-germ-cell-tumors-in-children-adolescents-lessons-learnt-over-a-decade

Küpesiz FT, Tüysüz G, Akınel A, Teknec A, Sivrice A, Melikoglu M, et al. Clinical characteristics and treatment outcomes of patients with malignant extracranial germ cell tumors: A 20-Year single-center experience. J Curr Pediatr. 2021;19:176-84.

İncesoy-Özdemir S, Ertem U, Şahin G, Bozkurt C, Yüksek N, Ören AC, et al. Clinical and epidemiological characteristics of children with germ cell tumors: A single center experience in a developing country. Turk J Pediatr. 2017;59:410–17.

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Published

2025-06-30

How to Cite

Nitipornsri, K., & Winaichatsak, A. (2025). Treatment of pediatric extracranial germ cell tumors: Outcomes and related factors. Thai Journal of Pediatrics, 64(2), 130–149. retrieved from https://he04.tci-thaijo.org/index.php/TJP/article/view/2958

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Original Articles