Survival of Children with Germ Cell Tumors in Ali Asghar Hospital since 1990 to 2003

Background and Objective: Germ cell tumor (GCT) accounts for approximately 2-3% of all malignancies in children. In this respect, about 20% of patients with GCT are still resistant to therapy. Materials and Methods: The cross-sectional strategy of this survey was undertaken on 57 patients with germ cell tumor who admitted to Ali Asghar Children hospital during the years 1990- 2003. In this study, information regarding sex, age, pathological findings, clinical signs, treatment, and survival (event-free survival) were gathered in order to have better treatment and follow-up. The obtained data were analyzed using SPSS software. Results: The findings showed that the mean age of patients was 4.9 ± 0.1 years (1 months-14 years). Meanwhile, 54% and 46% of patients were male and female respectively with a ratio of 1.1. Regarding site of involvement, 57.8% and 42% of patients had sacrococcygeal and gonadal tumors respectively. In addition, regarding their pathological typing, 61.4%, 12.2%, 14%, and 10.5% of them had yolk sac tumor, dysgerminoma, malignant teratoma, and embryonal carcinoma respectively. The most common clinical signs were buttock mass, testicular mass, an abdominal mass, and abdominal pain in 31.5%, 28%, 17.5%, and 10.5% of patients respectively. All of the patients were treated with chemotherapy (bleomycin, vinblastin, cisplat). Mean duration of followup was 48.4 months. In this regard, 31.5% of the patients were alive, no information was available for 15.7% of them, and 52.6% of cases were expired. Meanwhile, 70% of the patients had tumor relapse. In this regard, event-free survival (EFS) for patients was 42%. Conclusion: The analysis of the treated patients showed that extragonadal location of primary tumor (especially sacrococcygeal), level of AFP above 10 ng/ml in patients, an age equal to or greater than 6 months, and metastatic disease were the most unfavorable factors for overall survival .