700例儿童颅外生殖细胞肿瘤单中心临床诊疗总结

Summary of single-center clinical diagnosis and treatment of 700 cases of extracranial germ cell tumors in children

目的回顾单中心儿童颅外生殖细胞瘤诊治情况,分析总结儿童颅外生殖细胞瘤治疗效果和影响预后的因素。方法收集重庆医科大学附属儿童医院肿瘤外科2012年8月—2020年4月收治的700例颅外生殖细胞肿瘤患儿临床资料。按照性别、年龄、部位、病理类型、预后等因素分析。共收集成熟型畸胎瘤482例;未成熟畸胎瘤86例;恶性生殖细胞瘤132例。结果(1)成熟型畸胎瘤:2y-OS100%、EFS 98.3%,5y-OS 100%、EFS 97.9%。(2)未成熟型畸胎瘤:2y-OS 100%、EFS 94.1%,5y-OS 100%、EFS 92.4%。(3)恶性生殖细胞瘤:2y-OS96.6%、EFS 85.5%,5y-OS 96.6%、EFS 82.5%。原发部位及临床分期是影响预后的重要因素(P<0.05)。结论临床分期、肿瘤原发部位是影响生存率的重要因素,经规范综合治疗颅外生殖细胞肿瘤是治疗效果较好的儿童重大疾病。

Objective To review the diagnosis and treatment of extracranial germ cell tumors in children in a single-center and to analyze the therapeutic effect and prognostic factors of extracranial germ cell tumors in children.Methods Clinical data of 700 children with extracranial germ cell tumor admitted to the Department of Oncology,Children′s Hospital of Chongqing Medical University from August 2012 to April 2020 were collected.The gender,age,location,pathological type and prognostic factors were analyzed retrospectively.A total of 482 mature teratomas;86 immature teratomas;132 malignant germ cell tumors were collected.Results(1)mature teratomas:the 2-years overall survival(OS)rate was 100%,the 2-years events free survival(EFS)rate was 98.3%,5-years OS rate was 100%,5-years EFS rate was 97.9%.(2)Immature teratoma:2-years OS rate was 100%,2-years EFS rate was 94.1%,5-years OS rate was 100%,5-years EFS rate was 92.4%.(3)Malignant germ cell tumors:2-years OS rate was 96.6%,2-years EFS rate was 85.5%,5-years OS rate was 96.6%,5-years EFS rate was 82.5%.The primary site and clinical stage were important factors affecting prognosis(P<0.05).Conclusions Clinical stage and primary site were important factors affecting prognosis.After standardized comprehensive treatment,extracranial germ cell tumors is a major childhood disease that can be treated and has good therapeutic effects.