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Teratomas in infancy and childhood

U Göbel¹, G Calaminus, J Engert

¹Department of Pediatric Hematology and Oncology, Heinrich Heine University, Düsseldorf, Germany.

Medical and Pediatric Oncology

|June 2, 1998

Summary

Complete resection significantly improves relapse-free survival in pediatric teratomas. Incomplete resection increases relapse risk, particularly in immature teratomas, highlighting the need for adjuvant chemotherapy trials.

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Area of Science:

Pediatric Oncology
Surgical Oncology
Tumor Biology

Background:

Teratomas represent 42% of pediatric germ cell tumors.
Incidence of pediatric teratomas is 0.24/100,000.
Common primary sites include coccygeal, ovarian, testicular, and brain locations.

Purpose of the Study:

To analyze outcomes in children with teratomas.
To identify risk factors for relapse and disease-specific mortality.
To evaluate the impact of surgical resection and adjuvant chemotherapy.

Main Methods:

Retrospective analysis of 270 extracranial non-testicular teratoma cases.
Evaluation of relapse rates based on tumor maturity and resection status.
Kaplan-Meier estimation for relapse-free survival (RFS).

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Main Results:

Complete resection yielded a high RFS (0.96 +/- 0.01) compared to incomplete resection (0.56 +/- 0.09).
Incomplete resection and immaturity were key risk factors for relapse.
Relapse risk was 18% in immature teratomas, with 25% mortality and 41% experiencing mutilation.

Conclusions:

Adjuvant chemotherapy may reduce relapse rates and malignant transformations.
An international randomized trial is proposed to evaluate adjuvant chemotherapy's efficacy.
The trial aims to improve outcomes and reduce the need for disfiguring surgeries.