Staff View: Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia

Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia

Background: A higher incidence of pediatric intracranial germ cell tumors (iGCTs) in Asian countries compared with Western countries has been reported. In Malaysia, the literature regarding pediatric iGCTs have been nonexistent. The aim of this study was to review the management, survival, and long-...

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Main Authors:	Rajagopal, Revathi, Leong, Sheng Hoay, Jawin, Vida, Foo, Jen Chun, Ahmad Bahuri, Nor Faizal, Mun, Kein Seong, Azman, Raja Rizal, Loh, Jasmin, Yap, Tsiao Yi, Ariffin, Hany, Moreira, Daniel C., Gottardo, Nicholas G., Bouffet, Eric, Ganesan, Dharmendra
Format:	Article
Published:	2021
Subjects:	R Medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer) RJ Pediatrics
Online Access:	http://eprints.um.edu.my/26317/ https://doi.org/10.1097/MPH.0000000000002116
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spelling	my.um.eprints.263172022-02-18T08:36:02Z http://eprints.um.edu.my/26317/ Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia Rajagopal, Revathi Leong, Sheng Hoay Jawin, Vida Foo, Jen Chun Ahmad Bahuri, Nor Faizal Mun, Kein Seong Azman, Raja Rizal Loh, Jasmin Yap, Tsiao Yi Ariffin, Hany Moreira, Daniel C. Gottardo, Nicholas G. Bouffet, Eric Ganesan, Dharmendra R Medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer) RJ Pediatrics Background: A higher incidence of pediatric intracranial germ cell tumors (iGCTs) in Asian countries compared with Western countries has been reported. In Malaysia, the literature regarding pediatric iGCTs have been nonexistent. The aim of this study was to review the management, survival, and long-term outcomes of pediatric iGCTs at a single tertiary center in Malaysia. Patients and Methods: We retrospectively reviewed data from patients below 18 years of age with iGCTs treated at the University Malaya Medical Center (UMMC) from 1998 to 2017. Results: Thirty-four patients were identified, with a median follow-up of 3.54 years. Sixteen (47%) patients had pure germinoma tumors (PGs), and the remaining patients had nongerminomatous germ cell tumors (NGGCTs). The median age was 12 years, with a male:female ratio of 4.7:1. Abnormal vision, headache with vomiting, and diabetes insipidus were the commonest presenting symptoms. Twenty-eight patients received initial surgical interventions, 24 were treated with chemotherapy, and 28 received radiotherapy. Eight patients experienced relapses. The 5- and 10-year event-free survival rates were similar at 61.1%+/- 12.6% and 42.9%+/- 12.1% for PG and NGGCT, respectively. The 5- and 10-year overall survival rates were the same at 75.5%+/- 10.8% and 53.3%+/- 12.3% for PG and NGGCT, respectively. Four patients died of treatment-related toxicity. Most of the survivors experienced good quality of life with satisfactory neurologic status. Conclusions: The survival rate of childhood iGCTs in UMMC was inferior to that reported in developed countries. Late diagnosis, poor adherence to treatment, and treatment-related complications were the contributing factors. Although these results highlight a single institution experience, they most likely reflect similar treatment patterns, outcomes, and challenges in other centers in Malaysia. 2021-10 Article PeerReviewed Rajagopal, Revathi and Leong, Sheng Hoay and Jawin, Vida and Foo, Jen Chun and Ahmad Bahuri, Nor Faizal and Mun, Kein Seong and Azman, Raja Rizal and Loh, Jasmin and Yap, Tsiao Yi and Ariffin, Hany and Moreira, Daniel C. and Gottardo, Nicholas G. and Bouffet, Eric and Ganesan, Dharmendra (2021) Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia. Journal of Pediatric Hematology/Oncology, Publis. ISSN 1077-4114, DOI https://doi.org/10.1097/MPH.0000000000002116 <https://doi.org/10.1097/MPH.0000000000002116>. https://doi.org/10.1097/MPH.0000000000002116 doi:10.1097/MPH.0000000000002116
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	R Medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer) RJ Pediatrics
spellingShingle	R Medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer) RJ Pediatrics Rajagopal, Revathi Leong, Sheng Hoay Jawin, Vida Foo, Jen Chun Ahmad Bahuri, Nor Faizal Mun, Kein Seong Azman, Raja Rizal Loh, Jasmin Yap, Tsiao Yi Ariffin, Hany Moreira, Daniel C. Gottardo, Nicholas G. Bouffet, Eric Ganesan, Dharmendra Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia
description	Background: A higher incidence of pediatric intracranial germ cell tumors (iGCTs) in Asian countries compared with Western countries has been reported. In Malaysia, the literature regarding pediatric iGCTs have been nonexistent. The aim of this study was to review the management, survival, and long-term outcomes of pediatric iGCTs at a single tertiary center in Malaysia. Patients and Methods: We retrospectively reviewed data from patients below 18 years of age with iGCTs treated at the University Malaya Medical Center (UMMC) from 1998 to 2017. Results: Thirty-four patients were identified, with a median follow-up of 3.54 years. Sixteen (47%) patients had pure germinoma tumors (PGs), and the remaining patients had nongerminomatous germ cell tumors (NGGCTs). The median age was 12 years, with a male:female ratio of 4.7:1. Abnormal vision, headache with vomiting, and diabetes insipidus were the commonest presenting symptoms. Twenty-eight patients received initial surgical interventions, 24 were treated with chemotherapy, and 28 received radiotherapy. Eight patients experienced relapses. The 5- and 10-year event-free survival rates were similar at 61.1%+/- 12.6% and 42.9%+/- 12.1% for PG and NGGCT, respectively. The 5- and 10-year overall survival rates were the same at 75.5%+/- 10.8% and 53.3%+/- 12.3% for PG and NGGCT, respectively. Four patients died of treatment-related toxicity. Most of the survivors experienced good quality of life with satisfactory neurologic status. Conclusions: The survival rate of childhood iGCTs in UMMC was inferior to that reported in developed countries. Late diagnosis, poor adherence to treatment, and treatment-related complications were the contributing factors. Although these results highlight a single institution experience, they most likely reflect similar treatment patterns, outcomes, and challenges in other centers in Malaysia.
format	Article
author	Rajagopal, Revathi Leong, Sheng Hoay Jawin, Vida Foo, Jen Chun Ahmad Bahuri, Nor Faizal Mun, Kein Seong Azman, Raja Rizal Loh, Jasmin Yap, Tsiao Yi Ariffin, Hany Moreira, Daniel C. Gottardo, Nicholas G. Bouffet, Eric Ganesan, Dharmendra
author_facet	Rajagopal, Revathi Leong, Sheng Hoay Jawin, Vida Foo, Jen Chun Ahmad Bahuri, Nor Faizal Mun, Kein Seong Azman, Raja Rizal Loh, Jasmin Yap, Tsiao Yi Ariffin, Hany Moreira, Daniel C. Gottardo, Nicholas G. Bouffet, Eric Ganesan, Dharmendra
author_sort	Rajagopal, Revathi
title	Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia
title_short	Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia
title_full	Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia
title_fullStr	Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia
title_full_unstemmed	Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia
title_sort	challenges in the management of childhood intracranial germ cell tumors in middle-income countries: a 20-year retrospective review from a single tertiary center in malaysia
publishDate	2021
url	http://eprints.um.edu.my/26317/ https://doi.org/10.1097/MPH.0000000000002116
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score	13.211869

Challenges in the management of childhood intracranial germ cell tumors in middle-income countries: A 20-year retrospective review from a single tertiary center in Malaysia

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