BACKGROUND: In adolescents aged 10-15 years germ cell tumors of the testis (TGCT) are rare and information for a risk adapted therapy limited.
AIMS OF THE STUDY: The protocol MAHO 98 for patients (pts) with TGCTs is stratified according to age, stage and histology. Pts ≥ 10 years received after tumororchiectomy 2 courses (crs) PVB and restaging. Residual tumor was resected and therapy continued in regard to inital stage and response. Chemotherapy: PVB: cisplatin (20 mg/m²/day 1-5), vinblastine (3 mg/m²/day 1+2), and bleomycin (15 U/m²/day 1-3). For consolidation 1 crs PVB has been given to stage II patients with CR. In case of PR, 2 crs PEB (vinblastine substituted by etoposide 100 mg/m²/day 1-3) or relapse 3 crs PEI (bleomycin substituted by ifosfamide 1 500 mg/m²/day 1-5) were given.
RESULTS: Between Jan 1998 and Dec 2005, 34 pts (≥ 10 year) were registered, 31 fulfilled the inclusion criteria. Median age: 15;6 years; months (range 13;5-20;2 ). Lugano staging: IA n=14, IB n=2, IC n=3, IIA n=4, IIB n=6, IIC n=1, IIIC n=1. The stage IIIC pt received preoperative chemotherapy, all other pts had tumororchiectomy first. Residual tumor after 2 crs PVB was detected in 4 pts and was resected. Late relapses occurred in 2 pts and were cured by additional therapy. All patients are surviving.
CONCLUSION: Young patients with TGCT stage I and II have an excellent prognosis and further reduction of therapy has to be considered.
Written by:
Göbel U, Calaminus G, Haas R, Teske C, Schönberger S, Schneider DT, Leuschner I, Harms D. Are you the author?
Pediatric Oncology and Hematology, University Düsseldorf, Germany; Pediatric Hematology and Oncology, University Münster, Münster, Germany; Pediatric Hematology and Oncology, Ludwig-Maximilians-University -Munich, Munich, Germany; Pediatric Hematology and Oncology, University of Bonn, Bonn, Germany; Clinic for Pediatrics, Municipal Hospital, Dortmund, Germany; Kiel Paediatric Tumor Registry, Dept. of Paediatric Pathology, University of Kiel, Kiel, Germany.
Reference: Klin Padiatr. 2014 Nov;226(6-7):316-22.
doi: 10.1055/s-0034-1387748
PubMed Abstract
PMID: 25431864