TREATMENT OF EXTRACRANIAL GERM CELL TUMOURS IN HONG KONG
Lee
ACW1, Li CK2, Chan GCF3, Ling SC4,
Yuen HL5, on behalf of the Hong Kong Paediatric Haematology
& Oncology Study Group.
1Tuen
Mun Hospital, 2Prince of Wales Hospital, 3Queen Mary
Hospital, 4Princess Margaret Hospital, 5Queen
Elizabeth Hospital, Hong Kong, China
Objective:
To study the clinical outcome of extracranial germ cell tumours (GCT) in
children using a unified and risk-stratified treatment protocol in Hong
Kong.
Methods:
All children of age 15 or under diagnosed from January 1995 to December
2000 were recruited in this multi-centre study. Patients were staged
according to the extent of primary disease, whether the primary tumour was
completely resected, and the presence of regional lymph nodes or distant
metastasis. Patients with stage I or benign histology were kept under
observation after complete tumour resection. Patients with more advanced
disease received combination chemotherapy (carboplatin, etoposide and
bleomycin). a-Fetoprotein
and human chorionic gonadotrophin were monitored as tumour markers where
applicable during and after treatment.
Results:
49 children were diagnosed with GCT. They consisted of 25 boys and 24 girls
with a mean age of 4.4 (range 0.0-15.0) years. 22 (45%) patients had benign
teratoma whereas others had malignant GCT (yolk sac tumours, 16; others,
11). The primary sites included gonads (n=25), sacrococcygeal region
(n=10), mediastinum (n=8), and others (n=6). 30 (61%) patients were treated
with surgery alone. 19 (39%) patients received combination chemotherapy. At
a median follow up of 2.75 (range 0.1-6.0) years, the overall survival and
event free survival rates were 100% and 91.8%, respectively.
Conclusions:
With a risk-stratified approach and the judicious use of chemotherapeutic
agents, childhood GCT is a readily treatable neoplastic disease.