Pediatric and adolescent extracranial germ cell tumors: The road to collaboration Review uri icon

Overview

MeSH Major

  • Interdisciplinary Communication
  • International Cooperation
  • Medical Oncology
  • Neoplasms, Germ Cell and Embryonal
  • Pediatrics

abstract

  • During the past 35 years, survival rates for children with extracranial malignant germ cell tumors (GCTs) have increased significantly. Success has been achieved primarily through the application of platinum-based chemotherapy regimens; however, clinical challenges in GCTs remain. Excellent outcomes are not distributed uniformly across the heterogeneous distribution of age, histologic features, and primary tumor site. Despite good outcomes overall, the likelihood of a cure for certain sites and histologic conditions is less than 50%. In addition, there are considerable long-term treatment-related effects for survivors. Even modest cisplatin dosing can cause significant long-term morbidities. A particular challenge in designing new therapies for GCT is that a variety of specialists use different risk stratifications, staging systems, and treatment approaches for three distinct age groups (childhood, adolescence, and young adulthood). Traditionally, pediatric cancer patients younger than 15 years have been treated by pediatric oncologists in collaboration with their surgical specialty colleagues. Adolescents and young adults with GCTs often are treated by medical oncologists, urologists, or gynecologic oncologists. The therapeutic dilemma for all is how to best define disease risk so that therapy and toxicity can be appropriately reduced for some patients and intensified for others. Further clinical and biologic insights can only be achieved through collaborations that do not set limitations by age, sex, and primary tumor site. Therefore, international collaborations, spanning different cooperative groups and disciplines, have been developed to address these challenges.

authors

publication date

  • September 20, 2015

Research

keywords

  • Review

Identity

Language

  • eng

PubMed Central ID

  • PMC4979195

Digital Object Identifier (DOI)

  • 10.1200/JCO.2014.60.5337

PubMed ID

  • 26304902

Additional Document Info

start page

  • 3018

end page

  • 28

volume

  • 33

number

  • 27