Is surgical resection and observation sufficient for stage I and II sacrococcygeal germ cell tumors? A case series and review
Background Sacrococcygeal teratoma (SCT) is the most common germ cell tumor (GCT) of infancy. Up to 35% of infants may have malignant elements. The standard of care for SCT with malignant elements (SCT‐ME) has been surgery and chemotherapy. However, cases where low‐stage SCT‐ME have been successfull...
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| Veröffentlicht in: | Pediatric blood & cancer 2017-05, Vol.64 (5), p.np-n/a |
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| creator | Egler, Rachel A. Gosiengfiao, Yasmin Russell, Heidi Wickiser, Jonathan E. Frazier, A. Lindsay |
| description | Background
Sacrococcygeal teratoma (SCT) is the most common germ cell tumor (GCT) of infancy. Up to 35% of infants may have malignant elements. The standard of care for SCT with malignant elements (SCT‐ME) has been surgery and chemotherapy. However, cases where low‐stage SCT‐ME have been successfully observed following resection have been reported.
Procedure
To better understand the outcomes of low‐stage SCT‐ME that do not receive chemotherapy, we reviewed SCT pathology reports from five children's hospitals from 1999 to 2009. Information regarding staging workup, tumor markers, treatment, and outcome was collected for patients with stage I or II SCT‐ME. An English language literature review was also performed.
Results
Seventy‐four SCT were identified: 51 stage I and 23 stage II; 13 (18%) were SCT‐ME: 5 stage I and 8 stage II; four stage I and four stage II tumors were not treated with chemotherapy. No stage I tumors recurred; all of the stage II tumors recurred and were successfully salvaged, two had no ME at recurrence. We identified another 10 stage I SCT‐ME in the literature managed with active surveillance—two recurred and were successfully treated with surgery and chemotherapy.
Conclusions
Overall, of the 14 cases of stage I SCT‐ME, 12 survived with no recurrence and the two who did recur were successfully treated with platinum‐based chemotherapy (EFS = 86%, overall survival [OS] = 100%); this suggests that patients with stage I SCT‐ME could be observed after surgery and treated only upon recurrence. Stage II SCT‐ME require further study in a clinical trial setting. |
| doi_str_mv | 10.1002/pbc.26311 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1888955087</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1906214853</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4141-d2921b43784bba0ce1321c0c2b95dffe461ed6252eee9a9bc5ec4a38ba32ee293</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhS0Eoj-w4AWQJTZ0Ma3t2Im9Qu2In0iVYAFry3ZuRq6SePBNWs2Cd8czU7pAgtX1tT5_OvIh5A1nl5wxcbX14VLUFefPyClXUq0U483zpzMzJ-QM8a6gNVP6JTkRTaNrKfQp-dUixSVvYnADzYAQ5pgm6qaOJo-Q791hx6XvY4gwzbRPmeLsNkDbA9a2FF3IKaQQdhsomg3kkQYYBjovY8r4gV7T4BBo8UXAw6sM9xEeXpEXvRsQXj_Oc_Lj08fv6y-r26-f2_X17SpILvmqE0ZwL6tGS-8dC8ArwQMLwhvV9T3ImkNXCyUAwDjjg4IgXaW9q8qVMNU5eX_0bnP6uQDOdoy4T-gmSAtarrU2SjHdFPTdX-hdWvJU0lluWC241Kr6L6U1awzjcu-6OFLlexAz9Hab4-jyznJm983Z0pw9NFfYt4_GxY_QPZF_qirA1RF4iAPs_m2y327WR-VvDfmiBg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1880790147</pqid></control><display><type>article</type><title>Is surgical resection and observation sufficient for stage I and II sacrococcygeal germ cell tumors? A case series and review</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Egler, Rachel A. ; Gosiengfiao, Yasmin ; Russell, Heidi ; Wickiser, Jonathan E. ; Frazier, A. Lindsay</creator><creatorcontrib>Egler, Rachel A. ; Gosiengfiao, Yasmin ; Russell, Heidi ; Wickiser, Jonathan E. ; Frazier, A. Lindsay</creatorcontrib><description>Background
Sacrococcygeal teratoma (SCT) is the most common germ cell tumor (GCT) of infancy. Up to 35% of infants may have malignant elements. The standard of care for SCT with malignant elements (SCT‐ME) has been surgery and chemotherapy. However, cases where low‐stage SCT‐ME have been successfully observed following resection have been reported.
Procedure
To better understand the outcomes of low‐stage SCT‐ME that do not receive chemotherapy, we reviewed SCT pathology reports from five children's hospitals from 1999 to 2009. Information regarding staging workup, tumor markers, treatment, and outcome was collected for patients with stage I or II SCT‐ME. An English language literature review was also performed.
Results
Seventy‐four SCT were identified: 51 stage I and 23 stage II; 13 (18%) were SCT‐ME: 5 stage I and 8 stage II; four stage I and four stage II tumors were not treated with chemotherapy. No stage I tumors recurred; all of the stage II tumors recurred and were successfully salvaged, two had no ME at recurrence. We identified another 10 stage I SCT‐ME in the literature managed with active surveillance—two recurred and were successfully treated with surgery and chemotherapy.
Conclusions
Overall, of the 14 cases of stage I SCT‐ME, 12 survived with no recurrence and the two who did recur were successfully treated with platinum‐based chemotherapy (EFS = 86%, overall survival [OS] = 100%); this suggests that patients with stage I SCT‐ME could be observed after surgery and treated only upon recurrence. Stage II SCT‐ME require further study in a clinical trial setting.</description><identifier>ISSN: 1545-5009</identifier><identifier>EISSN: 1545-5017</identifier><identifier>DOI: 10.1002/pbc.26311</identifier><identifier>PMID: 27786428</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biomarkers, Tumor ; Chemotherapy ; Children ; Combined Modality Therapy ; Disease-Free Survival ; English language ; germ cell tumor ; Hematology ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Infants ; Language ; Literature reviews ; Neoplasm Recurrence, Local - drug therapy ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Neoplasms, Germ Cell and Embryonal - drug therapy ; Neoplasms, Germ Cell and Embryonal - pathology ; Neoplasms, Germ Cell and Embryonal - surgery ; Oncology ; Pathology ; Pediatrics ; Platinum ; Retrospective Studies ; Sacrococcygeal Region - pathology ; Sacrococcygeal Region - surgery ; sacrococcygeal teratoma ; Surgery ; surveillance ; Survival ; Teratoma ; Teratoma - pathology ; Tumor markers ; Tumors</subject><ispartof>Pediatric blood & cancer, 2017-05, Vol.64 (5), p.np-n/a</ispartof><rights>2016 Wiley Periodicals, Inc.</rights><rights>2017 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4141-d2921b43784bba0ce1321c0c2b95dffe461ed6252eee9a9bc5ec4a38ba32ee293</citedby><cites>FETCH-LOGICAL-c4141-d2921b43784bba0ce1321c0c2b95dffe461ed6252eee9a9bc5ec4a38ba32ee293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpbc.26311$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpbc.26311$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27786428$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egler, Rachel A.</creatorcontrib><creatorcontrib>Gosiengfiao, Yasmin</creatorcontrib><creatorcontrib>Russell, Heidi</creatorcontrib><creatorcontrib>Wickiser, Jonathan E.</creatorcontrib><creatorcontrib>Frazier, A. Lindsay</creatorcontrib><title>Is surgical resection and observation sufficient for stage I and II sacrococcygeal germ cell tumors? A case series and review</title><title>Pediatric blood & cancer</title><addtitle>Pediatr Blood Cancer</addtitle><description>Background
Sacrococcygeal teratoma (SCT) is the most common germ cell tumor (GCT) of infancy. Up to 35% of infants may have malignant elements. The standard of care for SCT with malignant elements (SCT‐ME) has been surgery and chemotherapy. However, cases where low‐stage SCT‐ME have been successfully observed following resection have been reported.
Procedure
To better understand the outcomes of low‐stage SCT‐ME that do not receive chemotherapy, we reviewed SCT pathology reports from five children's hospitals from 1999 to 2009. Information regarding staging workup, tumor markers, treatment, and outcome was collected for patients with stage I or II SCT‐ME. An English language literature review was also performed.
Results
Seventy‐four SCT were identified: 51 stage I and 23 stage II; 13 (18%) were SCT‐ME: 5 stage I and 8 stage II; four stage I and four stage II tumors were not treated with chemotherapy. No stage I tumors recurred; all of the stage II tumors recurred and were successfully salvaged, two had no ME at recurrence. We identified another 10 stage I SCT‐ME in the literature managed with active surveillance—two recurred and were successfully treated with surgery and chemotherapy.
Conclusions
Overall, of the 14 cases of stage I SCT‐ME, 12 survived with no recurrence and the two who did recur were successfully treated with platinum‐based chemotherapy (EFS = 86%, overall survival [OS] = 100%); this suggests that patients with stage I SCT‐ME could be observed after surgery and treated only upon recurrence. Stage II SCT‐ME require further study in a clinical trial setting.</description><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biomarkers, Tumor</subject><subject>Chemotherapy</subject><subject>Children</subject><subject>Combined Modality Therapy</subject><subject>Disease-Free Survival</subject><subject>English language</subject><subject>germ cell tumor</subject><subject>Hematology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Language</subject><subject>Literature reviews</subject><subject>Neoplasm Recurrence, Local - drug therapy</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>Neoplasms, Germ Cell and Embryonal - drug therapy</subject><subject>Neoplasms, Germ Cell and Embryonal - pathology</subject><subject>Neoplasms, Germ Cell and Embryonal - surgery</subject><subject>Oncology</subject><subject>Pathology</subject><subject>Pediatrics</subject><subject>Platinum</subject><subject>Retrospective Studies</subject><subject>Sacrococcygeal Region - pathology</subject><subject>Sacrococcygeal Region - surgery</subject><subject>sacrococcygeal teratoma</subject><subject>Surgery</subject><subject>surveillance</subject><subject>Survival</subject><subject>Teratoma</subject><subject>Teratoma - pathology</subject><subject>Tumor markers</subject><subject>Tumors</subject><issn>1545-5009</issn><issn>1545-5017</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0Eoj-w4AWQJTZ0Ma3t2Im9Qu2In0iVYAFry3ZuRq6SePBNWs2Cd8czU7pAgtX1tT5_OvIh5A1nl5wxcbX14VLUFefPyClXUq0U483zpzMzJ-QM8a6gNVP6JTkRTaNrKfQp-dUixSVvYnADzYAQ5pgm6qaOJo-Q791hx6XvY4gwzbRPmeLsNkDbA9a2FF3IKaQQdhsomg3kkQYYBjovY8r4gV7T4BBo8UXAw6sM9xEeXpEXvRsQXj_Oc_Lj08fv6y-r26-f2_X17SpILvmqE0ZwL6tGS-8dC8ArwQMLwhvV9T3ImkNXCyUAwDjjg4IgXaW9q8qVMNU5eX_0bnP6uQDOdoy4T-gmSAtarrU2SjHdFPTdX-hdWvJU0lluWC241Kr6L6U1awzjcu-6OFLlexAz9Hab4-jyznJm983Z0pw9NFfYt4_GxY_QPZF_qirA1RF4iAPs_m2y327WR-VvDfmiBg</recordid><startdate>201705</startdate><enddate>201705</enddate><creator>Egler, Rachel A.</creator><creator>Gosiengfiao, Yasmin</creator><creator>Russell, Heidi</creator><creator>Wickiser, Jonathan E.</creator><creator>Frazier, A. Lindsay</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope></search><sort><creationdate>201705</creationdate><title>Is surgical resection and observation sufficient for stage I and II sacrococcygeal germ cell tumors? A case series and review</title><author>Egler, Rachel A. ; Gosiengfiao, Yasmin ; Russell, Heidi ; Wickiser, Jonathan E. ; Frazier, A. Lindsay</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4141-d2921b43784bba0ce1321c0c2b95dffe461ed6252eee9a9bc5ec4a38ba32ee293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biomarkers, Tumor</topic><topic>Chemotherapy</topic><topic>Children</topic><topic>Combined Modality Therapy</topic><topic>Disease-Free Survival</topic><topic>English language</topic><topic>germ cell tumor</topic><topic>Hematology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Language</topic><topic>Literature reviews</topic><topic>Neoplasm Recurrence, Local - drug therapy</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Staging</topic><topic>Neoplasms, Germ Cell and Embryonal - drug therapy</topic><topic>Neoplasms, Germ Cell and Embryonal - pathology</topic><topic>Neoplasms, Germ Cell and Embryonal - surgery</topic><topic>Oncology</topic><topic>Pathology</topic><topic>Pediatrics</topic><topic>Platinum</topic><topic>Retrospective Studies</topic><topic>Sacrococcygeal Region - pathology</topic><topic>Sacrococcygeal Region - surgery</topic><topic>sacrococcygeal teratoma</topic><topic>Surgery</topic><topic>surveillance</topic><topic>Survival</topic><topic>Teratoma</topic><topic>Teratoma - pathology</topic><topic>Tumor markers</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Egler, Rachel A.</creatorcontrib><creatorcontrib>Gosiengfiao, Yasmin</creatorcontrib><creatorcontrib>Russell, Heidi</creatorcontrib><creatorcontrib>Wickiser, Jonathan E.</creatorcontrib><creatorcontrib>Frazier, A. Lindsay</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><jtitle>Pediatric blood & cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Egler, Rachel A.</au><au>Gosiengfiao, Yasmin</au><au>Russell, Heidi</au><au>Wickiser, Jonathan E.</au><au>Frazier, A. Lindsay</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is surgical resection and observation sufficient for stage I and II sacrococcygeal germ cell tumors? A case series and review</atitle><jtitle>Pediatric blood & cancer</jtitle><addtitle>Pediatr Blood Cancer</addtitle><date>2017-05</date><risdate>2017</risdate><volume>64</volume><issue>5</issue><spage>np</spage><epage>n/a</epage><pages>np-n/a</pages><issn>1545-5009</issn><eissn>1545-5017</eissn><abstract>Background
Sacrococcygeal teratoma (SCT) is the most common germ cell tumor (GCT) of infancy. Up to 35% of infants may have malignant elements. The standard of care for SCT with malignant elements (SCT‐ME) has been surgery and chemotherapy. However, cases where low‐stage SCT‐ME have been successfully observed following resection have been reported.
Procedure
To better understand the outcomes of low‐stage SCT‐ME that do not receive chemotherapy, we reviewed SCT pathology reports from five children's hospitals from 1999 to 2009. Information regarding staging workup, tumor markers, treatment, and outcome was collected for patients with stage I or II SCT‐ME. An English language literature review was also performed.
Results
Seventy‐four SCT were identified: 51 stage I and 23 stage II; 13 (18%) were SCT‐ME: 5 stage I and 8 stage II; four stage I and four stage II tumors were not treated with chemotherapy. No stage I tumors recurred; all of the stage II tumors recurred and were successfully salvaged, two had no ME at recurrence. We identified another 10 stage I SCT‐ME in the literature managed with active surveillance—two recurred and were successfully treated with surgery and chemotherapy.
Conclusions
Overall, of the 14 cases of stage I SCT‐ME, 12 survived with no recurrence and the two who did recur were successfully treated with platinum‐based chemotherapy (EFS = 86%, overall survival [OS] = 100%); this suggests that patients with stage I SCT‐ME could be observed after surgery and treated only upon recurrence. Stage II SCT‐ME require further study in a clinical trial setting.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27786428</pmid><doi>10.1002/pbc.26311</doi><tpages>5</tpages></addata></record> |
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| subjects | Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biomarkers, Tumor Chemotherapy Children Combined Modality Therapy Disease-Free Survival English language germ cell tumor Hematology Hospitals Humans Infant Infant, Newborn Infants Language Literature reviews Neoplasm Recurrence, Local - drug therapy Neoplasm Recurrence, Local - pathology Neoplasm Staging Neoplasms, Germ Cell and Embryonal - drug therapy Neoplasms, Germ Cell and Embryonal - pathology Neoplasms, Germ Cell and Embryonal - surgery Oncology Pathology Pediatrics Platinum Retrospective Studies Sacrococcygeal Region - pathology Sacrococcygeal Region - surgery sacrococcygeal teratoma Surgery surveillance Survival Teratoma Teratoma - pathology Tumor markers Tumors |
| title | Is surgical resection and observation sufficient for stage I and II sacrococcygeal germ cell tumors? A case series and review |
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