Characteristics and outcomes of pediatric testicular yolk Sac tumor

Maoxian Li; Jinkui Wang; Jianyu Wang; Deying Zhang; Yi Hua; Feng Liu; Peng Lu; Junhong Liu; Xing Liu; Tao Lin; Guanghui Wei; Dawei He

doi:10.3389/fped.2022.1024906

Characteristics and outcomes of pediatric testicular yolk Sac tumor

Front Pediatr. 2022 Dec 19:10:1024906. doi: 10.3389/fped.2022.1024906. eCollection 2022.

Authors

Maoxian Li^{1

2}, Jinkui Wang^{1

2}, Jianyu Wang^{1

2}, Deying Zhang^{1

2}, Yi Hua^{1

2}, Feng Liu^{1

2}, Peng Lu^{1

2}, Junhong Liu^{1

2}, Xing Liu^{1

2}, Tao Lin^{1

2}, Guanghui Wei^{1

2}, Dawei He^{1

2

3}

Affiliations

¹ Department of Urology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
² Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China.
³ Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Children's Hospital of Chongqing Medical University, Chongqing, China.

Abstract

Purpose: Pediatric testicular yolk sac tumor is a rare malignant germ cell tumor and there is a lack of large clinical studies. The purpose of this study is to summarize the clinical characteristics of pediatric testicular yolk tumor and evaluate the prognostic factors.

Materials and methods: The medical records of children with testicular yolk sac tumor in one pediatric medical centre in China from January 2005 to January 2021 were retrospectively investigated. Data regarding clinical characteristics, treatment and prognosis were collected.

Results: A total of 109 patients with a median diagnosed age of 18 months (range 2-69) were included in this study; of them 100 were diagnosed as stage I, 6 as stage II and 3 as stage IV. All patients underwent radical orchiectomy, and 61 of them underwent postoperative chemotherapy. The mean follow-up time was 61.3 months (range 3-259), during that time, 8 patients experienced relapse. The five-year overall survival was 90.6% (95% CI 84.6%-96.7%). Univariate Cox regression analysis showed that disease stage, relapse, maximum tumor diameter, and alpha-fetoprotein returning to normal within 2 months postoperatively were risk factors for survival (HRs of 25.43, 26.43, 1.48 and 0.08, respectively, p < 0.05). Multivariate Cox regression analysis suggested that higher disease stage and relapse were independent adverse factors for survival (HRs of 148.30 and 94.58, respectively, p < 0.05).

Conclusions: The prognosis of pediatric testicular yolk sac tumor is generally excellent. A higher disease stage and the occurrence of relapse could predict a poor prognosis. The individualized management of children with testicular yolk sac tumor according to risk classification is feasible.

Keywords: chemotherapy; pediatric; prognosis; relapse; testicular yolk sac tumor.