ĐẶC ĐIỂM CHẨN ĐOÁN VÀ ĐIỀU TRỊ U TẾ BÀO MẦM ÁC TÍNH NGOÀI SỌ TẠI BỆNH VIỆN NHI ĐỒNG 2

Abstract

Background and aims: Germ cell tumors are a group of malignancies that originate in sex cells during development and migration. Tumors can originate from the gonadal tract such as testes, ovaries, or extra-gonadal such as intracranial, mediastinal, sacral, uterine, vaginal and account for 3.5% of all childhood cancers. under 15 years old. Treatment options for germ cell malignancies include surgery, chemotherapy, and radiation therapy, of which radiotherapy is used less and less often because of the long-term consequences of radiation exposure in children. This study aims to investigate the diagnostic and treatment characteristics of extracranial germ cell tumor treated at Children's Hospital 2. Methods: A prospective descriptive case series study in all pediatric patients were diagnosed with extracranial malignant germ cell tumors at the Department of Hematology Oncology, Children's Hospital 2 from January 1, 2011 to July 31, 2019. ata were entered using REDCap software and analyzed using SPSS 20.0 software. Results: We recorded 69 patients who met the sampling criteria in which malignant germ cell tumors in the genital tract accounted for 69.6%, yolk sac tumor accounted for 59.4%. Median age was 25 months old. The most common symptom of the disease was tumor detection (60.9%) followed by abdominal pain (15%). The average tumor size is 8.4cm, the largest size is ovarian tumor, the smallest is testicular tumor. The median values of AFP and β-HCG were 3,083.2 ng/mL and 60 IU/mL, respectively. The most common histopathological type is yolk sac tumor, accounting for 59.4%. There were 31.9% tumors stage I, 15.9% stage II, 31.9% stage III and 13% stage IV. There were 29% low-risk, 30.4% medium-risk and 30.4% high-risk tumors. The mean duration of treatment was 119.1 days. The treatment method is surgery combined with chemotherapy. The main chemotherapy regimen is JEB accounted for 92.8%, PEb regimen accounted for 7.2%. Conclusions: Malignant extracranial germ cell tumors in children are mainly gonadal tumors, the common histology is yolk sac tumor. Median age of detection was 25 months, the most common symptom onset was abdominal pain, 44% of tumors were detected at stage III-IV and 30.3% at high risk. The mean duration of treatment was 119.1 days. The main chemotherapy regimen is JEB accounted for 92.8%, PEb regimen accounted for 7.2%.