Surgical Outcome of Pediatric Extracranial Germ Cell Tumors: 10 Years Single Center Experience.
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Date
2023-10
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Addis Ababa University
Abstract
Background: Pediatric germ cell tumors are a rare type of cancer in children, and they are
classified as a heterogeneous group that exhibits a wide range of clinical behavior, histology, and
location characteristics. Although there is sufficient data available on the clinicopathologic
characteristics of these tumors, there is a scarcity of information regarding their surgical
outcome, and the existing data is mostly based on a single institution's experience. Moreover,
there is limited knowledge about the epidemiology and surgical outcome of pediatric germ cell
tumors in developing countries, especially in Sub-Saharan Africa. This study aimed to examine
the early surgical outcome of pediatric extracranial germ cell tumors and the factors associated
with the surgical outcomes.
Methods: We analyzed the clinical data of patients who underwent surgery for extracranial germ
cell tumors at TASH. The study was conducted by reviewing the medical records of all patients
who were diagnosed with histologically confirmed germ cell tumors from January 1, 2013, to
January 1, 2023. We assessed the demographic features, clinical findings, laboratory results,
radiographic findings, intraoperative findings, perioperative complications, and pathology results
of the patients.
Results: A total of 45 patients with extracranial GCT were included in this study, comprising 35
females (77.8%) and 10 males (22.2%). The age of patients ranged from 1 day to 12 years, with a
median age of 12 months. The median duration of hospital stay was ten days, with an IQR of 11.
Fifteen patients experienced perioperative complications, including six with intraoperative
complications and ten with postoperative complications. On univariate analysis, the rate of
perioperative complications was positively associated with the need for intraoperative
transfusion (p = 0.015), and the rate of intraoperative complications was associated with the
degree of tumor maturation (p = 0.02).
Conclusions: The surgical treatment of germ cell tumors is associated with a significant rate of
perioperative complications. To improve surgical outcomes and reduce the risk of complications,
larger prospective studies using our series as a reference point are needed to identify factors that
predict surgical outcomes and develop effective strategies.
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Keywords
Germ cell tumors, Pediatric, Surgical outcome, Developing countries