PURPOSE: Prognostic factors were studied in children older than 1 year who were treated with chemotherapy for extracranial localized malignant non seminomatous germ cell tumors. PATIENTS AND METHODS: Data from two consecutive protocols were pooled. The TGM 85 (1985-1989) protocol consisted of alternating courses of cyclophosphamide, dactinomycin and vinblastine, bleomycin, and cisplatin at a dose of 100 mg/m(2) per course. The TGM 90 (1990-1994) protocol was initiated with carboplatin 400 mg/m(2) substituted for cisplatin as the only modification to the previous protocol. RESULTS: We examined alpha-fetoprotein (AFP) levels, disease stage, and primary site and identified three prognostic groups. Patients with a poor prognosis had either an AFP level >/= 10,000 ng/mL or stage III disease and a sacrococcygeal or mediastinal primary site; such patients represented 46% of the patient population and experienced a 43% 3-year failure-free survival rate and a 77% overall survival rate. Patients with a good prognosis had an AFP level less than 10,000 ng/mL, stage I or II disease, and a testicular, ovarian, perineal, or retroperitoneal primary site; such patients represented 22% of the patient population and experienced no treatment failures. The other patients were classified in the intermediate prognosis group and represented 37% of the patient population, with an 81% 3-year failure-free survival rate and a 92% overall survival rate. CONCLUSION: Initial AFP level, disease stage, and primary site are the most important prognostic factors in this analysis. Prognostic models for pediatric germ cell tumors should allow the stratification of patients for a risk-adapted approach to treatment.
PURPOSE: Prognostic factors were studied in children older than 1 year who were treated with chemotherapy for extracranial localized malignant non seminomatous germ cell tumors. PATIENTS AND METHODS: Data from two consecutive protocols were pooled. The TGM 85 (1985-1989) protocol consisted of alternating courses of cyclophosphamide, dactinomycin and vinblastine, bleomycin, and cisplatin at a dose of 100 mg/m(2) per course. The TGM 90 (1990-1994) protocol was initiated with carboplatin 400 mg/m(2) substituted for cisplatin as the only modification to the previous protocol. RESULTS: We examined alpha-fetoprotein (AFP) levels, disease stage, and primary site and identified three prognostic groups. Patients with a poor prognosis had either an AFP level >/= 10,000 ng/mL or stage III disease and a sacrococcygeal or mediastinal primary site; such patients represented 46% of the patient population and experienced a 43% 3-year failure-free survival rate and a 77% overall survival rate. Patients with a good prognosis had an AFP level less than 10,000 ng/mL, stage I or II disease, and a testicular, ovarian, perineal, or retroperitoneal primary site; such patients represented 22% of the patient population and experienced no treatment failures. The other patients were classified in the intermediate prognosis group and represented 37% of the patient population, with an 81% 3-year failure-free survival rate and a 92% overall survival rate. CONCLUSION: Initial AFP level, disease stage, and primary site are the most important prognostic factors in this analysis. Prognostic models for pediatric germ cell tumors should allow the stratification of patients for a risk-adapted approach to treatment.
Authors: A Lindsay Frazier; Juliet P Hale; Carlos Rodriguez-Galindo; Ha Dang; Thomas Olson; Matthew J Murray; James F Amatruda; Claire Thornton; G Suren Arul; Deborah Billmire; Furqan Shaikh; Farzana Pashankar; Sara Stoneham; Mark Krailo; James C Nicholson Journal: J Clin Oncol Date: 2014-12-01 Impact factor: 44.544
Authors: Thomas A Olson; Matthew J Murray; Carlos Rodriguez-Galindo; James C Nicholson; Deborah F Billmire; Mark D Krailo; Ha M Dang; James F Amatruda; Claire M Thornton; G Suren Arul; Sara J Stoneham; Farzana Pashankar; Daniel Stark; Furqan Shaikh; David M Gershenson; Allan Covens; Jean Hurteau; Sally P Stenning; Darren R Feldman; Peter S Grimison; Robert A Huddart; Christopher Sweeney; Thomas Powles; Luiz Fernando Lopes; Simone dos Santos Agular; Girish Chinnaswamy; Sahar Khaleel; Sherif Abouelnaga; Juliet P Hale; A Lindsay Frazier Journal: J Clin Oncol Date: 2015-08-24 Impact factor: 44.544
Authors: A Lindsay Frazier; Pavlina Rumcheva; Thomas Olson; Roger Giller; Barbara Cushing; John Cullen; Neyssa Marina; Wendy B London Journal: Pediatr Blood Cancer Date: 2008-04 Impact factor: 3.167