RESULTS OF GERM CELL
TUMOURS TREATMENT IN CHILDREN IN POLAND (YEARS 1998-2000)
S. Popadiuk1, M. Korzon1, P. Czauderna1,
W. Woźniak2,
V. Świątkiewicz2, J. Kowalczyk2, H.
Wiśniewska - Ślusarz2, M. Krawczuk- Rybak2, M.
Dzierżęga2, B. Łopatka2, J. Bogusławska – Jaworska2,
A. Chybicka2, M. Stolarska2
(1) Medical University in Gdańsk,
(2) (2) Polish Paediatric Group For Solid Tumuors
Germ cell tumours
constitute about 3% of all pediatric malignancies. Since 1998 the
multicenter trial was initiated in Poland.
Material
and methods: 44 children (aged from 1 mo. to 17 yrs – mean 80 mo.) were
registered. There were 16 boys and 28 girls. Diagnosis was made upon
clinical and biochemical findings (elevated AFP) in 7 cases. In remaining
37 pts. tumour biopsy was undertaken. Microscopic diagnosis was as
followed: mixed germ cell tumours – 10, yolk sac tumour –15, embryonal carcinoma – 4, germinoma
– 4, immature teratomas – 4. AFP was elevated in 34 pts. (from 27 – 63.000
ng/ml); in 16 children it was over 15.000. The tumour was localised in:
ovaries (16), testicles (7), sacrococcygeal region (16), mediastinum (3)
and in 2 pts. the disease was disseminated at dgn. Following disease stages
were identified: I – 5 cases, II – 12 cases, III – 16 pts., IV – 11 pts.
All patients were treated according to French TGM’95 protocol. 22 belonged
to high risk and 22 to standard risk group. In 38 pts. who completed
treatment: 35 underwent surgery (primary – 22, secondary – 13 and both 4),
while chemotherapy was applied in 36 pts. (neo-adjuvant in 17).
Results: 38 children
completed treatment, 6 continues therapy. Among children who were off therapy, 34 (89%) are ANED (32 in
CR1 and 2 in CR2). Median time of follow-up is 24 mo. 4 children died: two
due to disease progression and two due to therapy complications (sepsis).
Radical surgery was performed in 25 cases (in 3 delayed, 22 primary
fashion). Survival in high risk group is 17/20 (85%), while in standard
risk group is 17/18 (94%).
Conclusions:1. Frequency of
germ cell tumours in Poland is about 2%. 2. Preliminary treatment results
seem to be promising although follow-up is relatively short. 3. Toxicity of
the applied protocol seem to be acceptable.