Related Experiment Video
Updated: Sep 13, 2025
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Factors Associated with Survival in Pediatric Extracranial Germ Cell Tumors: A Study Focusing on Postoperative
Sasabong Tiyaamornwong1, Polathep Vichitkunakorn2, Pornpun Sripornsawan3
1Department of pediatric surgery, Faculty of Prince of Songkla university, Thailand.
Insights
Serial alpha-fetoprotein (AFP) monitoring after surgery for pediatric extracranial germ cell tumors (eGCT) helps predict survival. Normalizing AFP levels within one month indicates a better prognosis and aids in identifying patients needing closer follow-up for recurrence.
Area of Science:
- Pediatric Oncology
- Biomarker Research
- Germ Cell Tumors
Background:
- Alpha-fetoprotein (AFP) is a biomarker used in managing pediatric extracranial germ cell tumors (eGCT).
- The prognostic significance of AFP in eGCT patient outcomes remains uncertain.
- Investigating serial AFP changes post-surgery is crucial for understanding its predictive value.
Purpose of the Study:
- To evaluate the prognostic role of serial alpha-fetoprotein (AFP) measurements after surgery in pediatric extracranial germ cell tumors (eGCT).
- To assess the impact of AFP level changes on overall survival (OS) and recurrence-free survival (RFS).
Main Methods:
- Analysis of data from 129 pediatric eGCT patients (age 0-15) who underwent surgical treatment.
- Evaluation of overall survival (OS) and recurrence-free survival (RFS).
- Serial postoperative AFP measurements were conducted for non-benign eGCT cases.
Main Results:
- Overall survival (OS) was 87.4% and recurrence-free survival (RFS) was 82.6%.
- Factors associated with poorer survival included male sex, non-sacrococcygeal extragonadal site, yolk sac tumor/choriocarcinoma histology, initial AFP > 50,000 ng/mL, and operative complications.
- AFP normalization (<100 ng/mL) at one month post-surgery correlated with improved 5-year OS (93.4% vs. 69.4%, p=0.031), with significant differences in log-AFP values between survivors and non-survivors from one month onward.
Conclusions:
- Serial AFP measurements starting one month post-surgery possess significant prognostic value in pediatric eGCT.
- Patients with persistently elevated AFP levels post-surgery require vigilant monitoring for potential tumor recurrence.
- Early identification of patients at higher risk of recurrence can guide timely therapeutic adjustments.
Background:
Alpha-fetoprotein (AFP) is commonly used in the management of pediatric extracranial germ cell tumors (eGCT), but its prognostic role remains unclear. We investigated survival outcomes and the impact of serial AFP changes after surgery.
Method:
We analyzed data from 129 pediatric eGCT patients (age 0-15) who underwent surgery at our institution. We evaluated overall survival (OS) and recurrence-free survival (RFS). in non-benign eGCTs, serial AFP measurements were performed postoperatively.
Results:
OS and RFS were 87.4% and 82.6%, respectively. Poorer survival was associated with male sex, non-sacrococcygeal extragonadal site, yolk sac tumor/choriocarcinoma histology, initial AFP > 50,000 ng/mL, and operative complications. Postoperative log-AFP values showed significant differences between long-term survivors and non-survivors from one month onwards. AFP normalization (<100 ng/mL) at one month was associated with improved 5-year OS (93.4% vs. 69.4%, p=0.031).
Conclusion:
Serial AFP measurement from one month post-surgery has prognostic value in pediatric eGCT. Patients who fail to normalize AFP should be closely monitored for recurrence.
