Outcome of Germ Cell Tumors in Children after Surgical Management; A Longitudinal Study

Aim: To assess the outcome of germ cell tumors in children after surgical management.

Study Design: A longitudinal study.

Place and duration: Pediatric surgery and oncology department of the national institute of child health Karachi from January 2017 to December 2018.

Methodology: A total of 79 children between the ages of 0 to 12 years were included in the study. Baseline, ultrasound, CT scan, tumor markers, and biopsy for tissue diagnosis were done. After surgical excision, they were followed up for 12 months with tumor markers, ultrasound and CT Scans for any recurrence. We just observed patients with mature teratoma and did surveillance for immature variety. The rest of the subtypes received JEB chemotherapy (carboplatin, etoposide, and bleomycin) as per UK-based chemotherapy protocol according to their disease stage.

Results: Most common age of presentation was < 1 month old. The antenatal diagnosis was made in 2 (2.5%) children. Sacrococcygeal region 54 (68.3%) was the most commonly involved region followed by gonads in 17 (21.5%) cases. According to histology mature teratoma was present in 32 (40.5%) children. Complete resection was done in 52 (65.8%) children. Recurrence occurred in one child and 3 children expired.

Conclusion: In the current study, the general outcome was good in terms of complete excision in most of the patients. Worst outcome noted in yolk sac tumor. There was a minimal recurrence rate.