title: Long-term follow-up and residual sequelae after treatment for intracerebral germ-cell tumour in children and adolescents.
abstract: BACKGROUND
  Information on long-term follow-up of children and adolescents treated for intracerebral germ-cell tumour is scant. We report on the results of a small series of patients treated at a single institution.
  
  
  METHODS
  Hospital records from 15 patients treated between 1980 and 1998 were reviewed. An attempt was made to correlate sequelae to tumour location and treatment modalities.
  
  
  RESULTS
  This cohort constitutes 5.5% of all brain tumours diagnosed at our institution.
  
  
  RESULTS
  10 germinomas, 2 benign teratomas, 2 malignant teratomas, and one mixed germ-cell tumour. Overall survival was 87%, with a mean follow-up time of 7 years and 8 months. The majority of patients have long-term sequelae involving one or several organ systems. In 66% endocrine, in 47% ophthalmologic, in 60% neuropsychological defects were observed. Endocrine and ophthalmologic sequelae show a correlation to tumour location. Neuropsychological long-term abnormalities are frequent and are associated with cranial irradiation in particular at young age, but less with tumour location, irradiation dose or surgery.
  
  
  CONCLUSIONS
  Our preliminary data suggest that today intracerebral germinomas and mature teratomas have a good prognosis even when a relapse occurs. The outcome for mixed germ-cell tumours and malignant teratomas is less favourable. Although long-term sequelae are present in the majority of patients, there is some evidence that patients treated after 1990 suffer fewer severe long-term defects, thereby indicating that recent treatment protocols may result in a reduction of sequelae.
authors.affiliation: University Children's Hospital, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Schmugge
authors.forename: E
authors.initials: E
authors.lastname: Boltshauser
authors.forename: H J
authors.initials: HJ
authors.lastname: Plüss
authors.forename: F K
authors.initials: FK
authors.lastname: Niggli
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004703:Endocrine System; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D009483:Neuropsychological Tests; D011183:Postoperative Complications; D011379:Prognosis; D011878:Radiotherapy / Q000009:adverse effects; D016019:Survival Analysis; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology