Malignant retroperitoneal and abdominal germ cell tumors

An intergroup study

D. Billmire, C. Vinocur, F. Rescorla, Paul Colombani, B. Cushing, E. Hawkins, M. Davis, W. B. London, S. Lauer, R. Giller, P. L. Glick, D. Cass

Research output: Contribution to journalArticle

Abstract

Background/Purpose: This randomized study examined survival (S) and event-free survival (EFS) rates using high-or standard-dose cisplatin-based combination chemotherapy and surgical resection for this subset of germ cell tumors. Methods: Twenty-six of 317 patients enrolled on the POG 9049/COG 8882 intergroup study for malignant germ cell tumors had abdomen or retroperitoneum as the primary site. Twenty-five of 26 were eligible for inclusion (n = 25). Patients had biopsy or resection at diagnosis and randomization to chemotherapy including etoposide, bleomycin, and either standard-dose (PEB) or high-dose cisplatin (HDPEB). In patients with initial biopsy, delayed resection was planned. Results: Median age was 26 months. There were 14 girls and 11 boys. There were 3 stage I to II, 5 stage III, and 17 stage IV patients. Surgical management included primary resection in 5, resection after chemotherapy in 13, and biopsy or partial resection in 7 patients. Overall 6-year EFS rate was 82.8% ± 10.9%, and 6-year survival rate was 87.6% ± 9.3%. By group, 6-year survival rate was 90.0% ± 11.6% for PEB and 85.7 ± 14.5% for HDPEB. Deaths include one from sepsis, one from malignant tumor progression, and one from bulky disease caused by benign components despite response of the malignant elements to chemotherapy. Conclusions: Malignant germ cell tumors arising in the abdomen and retroperitoneum have an excellent prognosis despite advanced stage in most children. Aggressive resection need not be undertaken at diagnosis, but a concerted attempt at complete surgical removal after chemotherapy is important to distinguish viable tumor from necrotic tumor or benign elements that will not benefit from further chemotherapy.

Original languageEnglish (US)
Pages (from-to)315-318
Number of pages4
JournalJournal of Pediatric Surgery
Volume38
Issue number3
DOIs
StatePublished - Mar 1 2003
Externally publishedYes

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Germ Cell and Embryonal Neoplasms
Drug Therapy
Survival Rate
Biopsy
Abdomen
Cisplatin
Disease-Free Survival
Neoplasms
Bleomycin
Response Elements
Etoposide
Random Allocation
Combination Drug Therapy
Sepsis
Survival

Keywords

  • Endodermal sinus tumor
  • Malignant germ cell tumor
  • Retroperitoneal tumor

ASJC Scopus subject areas

  • Surgery

Cite this

Billmire, D., Vinocur, C., Rescorla, F., Colombani, P., Cushing, B., Hawkins, E., ... Cass, D. (2003). Malignant retroperitoneal and abdominal germ cell tumors: An intergroup study. Journal of Pediatric Surgery, 38(3), 315-318. https://doi.org/10.1053/jpsu.2003.50100

Malignant retroperitoneal and abdominal germ cell tumors : An intergroup study. / Billmire, D.; Vinocur, C.; Rescorla, F.; Colombani, Paul; Cushing, B.; Hawkins, E.; Davis, M.; London, W. B.; Lauer, S.; Giller, R.; Glick, P. L.; Cass, D.

In: Journal of Pediatric Surgery, Vol. 38, No. 3, 01.03.2003, p. 315-318.

Research output: Contribution to journalArticle

Billmire, D, Vinocur, C, Rescorla, F, Colombani, P, Cushing, B, Hawkins, E, Davis, M, London, WB, Lauer, S, Giller, R, Glick, PL & Cass, D 2003, 'Malignant retroperitoneal and abdominal germ cell tumors: An intergroup study', Journal of Pediatric Surgery, vol. 38, no. 3, pp. 315-318. https://doi.org/10.1053/jpsu.2003.50100
Billmire, D. ; Vinocur, C. ; Rescorla, F. ; Colombani, Paul ; Cushing, B. ; Hawkins, E. ; Davis, M. ; London, W. B. ; Lauer, S. ; Giller, R. ; Glick, P. L. ; Cass, D. / Malignant retroperitoneal and abdominal germ cell tumors : An intergroup study. In: Journal of Pediatric Surgery. 2003 ; Vol. 38, No. 3. pp. 315-318.
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abstract = "Background/Purpose: This randomized study examined survival (S) and event-free survival (EFS) rates using high-or standard-dose cisplatin-based combination chemotherapy and surgical resection for this subset of germ cell tumors. Methods: Twenty-six of 317 patients enrolled on the POG 9049/COG 8882 intergroup study for malignant germ cell tumors had abdomen or retroperitoneum as the primary site. Twenty-five of 26 were eligible for inclusion (n = 25). Patients had biopsy or resection at diagnosis and randomization to chemotherapy including etoposide, bleomycin, and either standard-dose (PEB) or high-dose cisplatin (HDPEB). In patients with initial biopsy, delayed resection was planned. Results: Median age was 26 months. There were 14 girls and 11 boys. There were 3 stage I to II, 5 stage III, and 17 stage IV patients. Surgical management included primary resection in 5, resection after chemotherapy in 13, and biopsy or partial resection in 7 patients. Overall 6-year EFS rate was 82.8{\%} ± 10.9{\%}, and 6-year survival rate was 87.6{\%} ± 9.3{\%}. By group, 6-year survival rate was 90.0{\%} ± 11.6{\%} for PEB and 85.7 ± 14.5{\%} for HDPEB. Deaths include one from sepsis, one from malignant tumor progression, and one from bulky disease caused by benign components despite response of the malignant elements to chemotherapy. Conclusions: Malignant germ cell tumors arising in the abdomen and retroperitoneum have an excellent prognosis despite advanced stage in most children. Aggressive resection need not be undertaken at diagnosis, but a concerted attempt at complete surgical removal after chemotherapy is important to distinguish viable tumor from necrotic tumor or benign elements that will not benefit from further chemotherapy.",
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T2 - An intergroup study

AU - Billmire, D.

AU - Vinocur, C.

AU - Rescorla, F.

AU - Colombani, Paul

AU - Cushing, B.

AU - Hawkins, E.

AU - Davis, M.

AU - London, W. B.

AU - Lauer, S.

AU - Giller, R.

AU - Glick, P. L.

AU - Cass, D.

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N2 - Background/Purpose: This randomized study examined survival (S) and event-free survival (EFS) rates using high-or standard-dose cisplatin-based combination chemotherapy and surgical resection for this subset of germ cell tumors. Methods: Twenty-six of 317 patients enrolled on the POG 9049/COG 8882 intergroup study for malignant germ cell tumors had abdomen or retroperitoneum as the primary site. Twenty-five of 26 were eligible for inclusion (n = 25). Patients had biopsy or resection at diagnosis and randomization to chemotherapy including etoposide, bleomycin, and either standard-dose (PEB) or high-dose cisplatin (HDPEB). In patients with initial biopsy, delayed resection was planned. Results: Median age was 26 months. There were 14 girls and 11 boys. There were 3 stage I to II, 5 stage III, and 17 stage IV patients. Surgical management included primary resection in 5, resection after chemotherapy in 13, and biopsy or partial resection in 7 patients. Overall 6-year EFS rate was 82.8% ± 10.9%, and 6-year survival rate was 87.6% ± 9.3%. By group, 6-year survival rate was 90.0% ± 11.6% for PEB and 85.7 ± 14.5% for HDPEB. Deaths include one from sepsis, one from malignant tumor progression, and one from bulky disease caused by benign components despite response of the malignant elements to chemotherapy. Conclusions: Malignant germ cell tumors arising in the abdomen and retroperitoneum have an excellent prognosis despite advanced stage in most children. Aggressive resection need not be undertaken at diagnosis, but a concerted attempt at complete surgical removal after chemotherapy is important to distinguish viable tumor from necrotic tumor or benign elements that will not benefit from further chemotherapy.

AB - Background/Purpose: This randomized study examined survival (S) and event-free survival (EFS) rates using high-or standard-dose cisplatin-based combination chemotherapy and surgical resection for this subset of germ cell tumors. Methods: Twenty-six of 317 patients enrolled on the POG 9049/COG 8882 intergroup study for malignant germ cell tumors had abdomen or retroperitoneum as the primary site. Twenty-five of 26 were eligible for inclusion (n = 25). Patients had biopsy or resection at diagnosis and randomization to chemotherapy including etoposide, bleomycin, and either standard-dose (PEB) or high-dose cisplatin (HDPEB). In patients with initial biopsy, delayed resection was planned. Results: Median age was 26 months. There were 14 girls and 11 boys. There were 3 stage I to II, 5 stage III, and 17 stage IV patients. Surgical management included primary resection in 5, resection after chemotherapy in 13, and biopsy or partial resection in 7 patients. Overall 6-year EFS rate was 82.8% ± 10.9%, and 6-year survival rate was 87.6% ± 9.3%. By group, 6-year survival rate was 90.0% ± 11.6% for PEB and 85.7 ± 14.5% for HDPEB. Deaths include one from sepsis, one from malignant tumor progression, and one from bulky disease caused by benign components despite response of the malignant elements to chemotherapy. Conclusions: Malignant germ cell tumors arising in the abdomen and retroperitoneum have an excellent prognosis despite advanced stage in most children. Aggressive resection need not be undertaken at diagnosis, but a concerted attempt at complete surgical removal after chemotherapy is important to distinguish viable tumor from necrotic tumor or benign elements that will not benefit from further chemotherapy.

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