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Pediatric Surgery International
Published in: Pediatric Surgery International 2/2017

01-02-2017 | Original Article

Long-term outcomes of pediatric and adolescent mediastinal germ cell tumors: a single pediatric oncology institutional experience

Authors: D. F. Grabski, A. S. Pappo, M. J. Krasin, A. M. Davidoff, B. N. Rao, I. Fernandez-Pineda

Published in: Pediatric Surgery International | Issue 2/2017

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Abstract

Purpose

To evaluate the epidemiologic, demographic, and clinical characteristics, as well as prognostic factors and long-term outcomes of mediastinal germ cell tumors (MGCT) in children.

Patients and methods

A retrospective study of pediatric patients diagnosed with a primary MGCT between January 1963 and August of 2014 was performed.

Results

Twenty-five patients were identified. Six children with teratomas were treated with resection alone (median age 7.8 years, range newborn to 15 years) and were cured without recurrence or progression. Nineteen children were treated for a malignant MGCT (median age 11.7 years, range 7 months–18 years); 5 year overall survival (OS) was 0.39 ± 0.12. For malignant non-seminomatous mediastinal germ cell tumors, platinum-based chemotherapy regimen (OS 0.56 vs 0.14, p = 0.03), complete surgical resection with negative margins (OS 0.73 vs 0.11, p = 0.03); and localized disease (OS 0.76 vs 0.0, p = 0.004) demonstrated a survival advantage.

Conclusions

Initial surgical resection is appropriate for teratomas. Localized disease, complete resection, and platinum-based chemotherapy are associated with improved survival in malignant non-seminomatous mediastinal germ cell tumors. Neoadjuvant, platinum-based three drug regimens followed by delayed surgical resection is the appropriate treatment modality for malignant mediastinal germ cell tumors.
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Metadata
Title
Long-term outcomes of pediatric and adolescent mediastinal germ cell tumors: a single pediatric oncology institutional experience
Authors
D. F. Grabski
A. S. Pappo
M. J. Krasin
A. M. Davidoff
B. N. Rao
I. Fernandez-Pineda
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 2/2017
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-016-4020-0

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