Extracranial germ cell tumours: Mature and immature (1990-2015). First report by the South African Association of Paediatric Haematology Oncology (SAAPHO)

Marc Hendricks¹, Annibale Cois^{2

3}, Jennifer Geel⁴, Jaques van Heerden^{5

6}, Gita Naidu⁷, Jan du Plessis⁸, Anel van Zyl⁵, Mairi Bassingthwaighte⁷, Fareed Omar⁹, Ané Büchner⁹, Biance Rowe⁷, Karla Thomas¹⁰, Ronelle Uys⁵, Ngoakoana Mahlachana⁷, Alan Davidson¹, A Lindsay Frazier L¹¹, Kirsten A Donald¹², Mariana Kruger M⁵

Affiliations

¹ Haematology Oncology Service, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
² Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
³ Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁴ Division of Paediatric Haematology Oncology, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, University of Witwatersrand, Johannesburg, South Africa.
⁵ Paediatric Haematology Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa.
⁶ Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.
⁷ Division of Paediatric Haematology Oncology, Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, Soweto, South Africa.
⁸ Division of Paediatric Haematology Oncology, Department of Paediatrics, Universitas Hospital, University of the Free State, Bloemfontein, South Africa.
⁹ Paediatric Haematology Oncology, Department of Paediatrics, Steve Biko Academic Hospital, University of Pretoria, Tshwane, South Africa.
¹⁰ Paediatric Haematology Oncology, Department of Paediatrics and Child Health, Frere Hospital, East London, South Africa.
¹¹ Paediatric Oncology, Dana Farber Cancer Institute/Boston Children's Cancer and Blood Disorder Centre, Harvard University, Boston, Massachusetts, USA.
¹² Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and the Neuroscience Institute, University of Cape Town, Cape Town, South Africa.

PMID: 37872125
DOI: 10.1002/pbc.30723

Extracranial germ cell tumours: Mature and immature (1990-2015). First report by the South African Association of Paediatric Haematology Oncology (SAAPHO)

Marc Hendricks et al. Pediatr Blood Cancer. 2024 Jan.

. 2024 Jan;71(1):e30723.

doi: 10.1002/pbc.30723. Epub 2023 Oct 23.

Authors

Affiliations

¹ Haematology Oncology Service, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
² Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
³ Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
⁴ Division of Paediatric Haematology Oncology, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, University of Witwatersrand, Johannesburg, South Africa.
⁵ Paediatric Haematology Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa.
⁶ Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.
⁷ Division of Paediatric Haematology Oncology, Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, Soweto, South Africa.
⁸ Division of Paediatric Haematology Oncology, Department of Paediatrics, Universitas Hospital, University of the Free State, Bloemfontein, South Africa.
⁹ Paediatric Haematology Oncology, Department of Paediatrics, Steve Biko Academic Hospital, University of Pretoria, Tshwane, South Africa.
¹⁰ Paediatric Haematology Oncology, Department of Paediatrics and Child Health, Frere Hospital, East London, South Africa.
¹¹ Paediatric Oncology, Dana Farber Cancer Institute/Boston Children's Cancer and Blood Disorder Centre, Harvard University, Boston, Massachusetts, USA.
¹² Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and the Neuroscience Institute, University of Cape Town, Cape Town, South Africa.

PMID: 37872125
DOI: 10.1002/pbc.30723

Abstract

Background and objectives: Outcomes of rare paediatric teratomas have not previously been reported nor treatment regimens standardised in low- and middle-income settings. We sought to evaluate treatment outcomes of children and adolescents with histologically confirmed extracranial germ cell tumours, both mature teratomas (MT) and immature teratomas (IT) in preparation for the development of the South African national treatment guideline.

Methods: Retrospective data by folder review were collated from nine South African paediatric oncology units. Kaplan-Meier analysis with Cox regression was performed to determine 5-year overall survival (OS) and prognostic factors.

Results: From January 1990 to December 2015, 60 patients were diagnosed with MTs; 14 males (median age 2 months; interquartile range [IQR]: 0-8.75 months) and 46 females (median age 9 months; IQR: 0-88.5 months). Forty patients were diagnosed with ITs; 10 males (median age less than 1 month; IQR: 0-1.75 months) and 30 females (median age 4.5 months; IQR: 1-162 months). There were high rates of upfront surgical resections in patients with MTs (58/60; 96.6%) and ITs (36/40; 90%), and similarly satisfactory rates of complete resection in patients with both MTs (55/60; 91.7%) and ITs (32/40; 80%). The 5-year OS for the whole group was 85.4%, significantly influenced by stage: Stage I (96.9%), Stage II (100%), Stage III (38.9%) (p < .001 [MT]; p = .013 [IT]). The event-free survival (EFS) ratio for the whole cohort was 78.7%.

Conclusions: Five-year OS for those with low-stage disease was excellent, but was poorer for patients with advanced disease. The implementation of a national treatment guideline will facilitate the standardising of surgical approaches, indications for chemotherapy and specifications for follow-up to improve survival and to collect more robust late effects data.

Keywords: immature teratoma; low- and middle-income country; mature teratoma.

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References

REFERENCES

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Extracranial germ cell tumours: Mature and immature (1990-2015). First report by the South African Association of Paediatric Haematology Oncology (SAAPHO)

Affiliations

Extracranial germ cell tumours: Mature and immature (1990-2015). First report by the South African Association of Paediatric Haematology Oncology (SAAPHO)

Authors

Affiliations

Abstract

References

REFERENCES

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical