Clinico Pathological Patterns and Treatment Outcomes of Pediatric Germ Cell Tumors Treated at Tikur Anbessa Hospital: A 10-Year Single Tertiary Hospital Experience
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Date
2024-04
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Addis Ababa University
Abstract
Background:Pediatric Germ Cell Tumors (GCTs) are rare heterogeneous neoplasms with a peak incidence in
children younger than 4 years old and during adolescence. The clinical presentation and treatment
outcomes of GCTs are not well-studied in developing countries. The main aim of this study was
to assess the clinic-pathological patterns and treatment outcomes of Pediatric Germ Cell Tumor
(GCT) patients treated at Tikur Anbessa Specialized Hospital.
Methods: A retrospective, cross-sectional study was conducted at Tikur Anbessa Specialized
Hospital on Pediatric Germ Cell tumor patients treated from January 1, 2014, to December 31,
2023. The collected data were analyzed using a statistical package for social sciences (SPSS)
version 25. The Kaplan–Meier Survival estimate was used to assess the Overall Survival (OS) and
Event-Free Survival (EFS).
Results: A total of ninety-one patients were included in the study. The median age at diagnosis
was 4 years with a female-to-male ratio of 2.3:1. Most patients were under five years of age;
constituting 61.6% (n=56). The duration of the illness from the onset of symptoms to the oncologic
treatment center ranged from 2 days to 12 months with a mean duration of four months.
Sacrococcygeal swelling was the commonest presenting symptom accounting for 38.2% (n=34)
followed by abdominal mass (36%). Most of the patients had extracranial GCTs constituting
93.4% (n=85). Mature teratoma was the most common histology of GCTs constituting 52.6%
followed by dysgerminomas (17.1%, n=13). About 42% of patients received a combination of
chemotherapy and local control measures either surgery or radiotherapy. The Kaplan-Meier
survival estimates showed the first and five-year OS was 95.7% and 85%, respectively. The first
and five-year EFS was 95% and 84 % respectively.
Conclusion:Our study showed the mean duration of the illness from the onset of symptoms to the oncologic
treatment center was 4 months. Mature teratoma was the commonest histology. The 1-year and 5-
year OS probabilities were better than other studies in similar settings.
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Keywords
Germ cell tumors, Pediatric, Histology, Chemotherapy, treatment outcome, Ethiopia