title: Paediatric extracranial germ cell tumours: a retrospective review.
abstract: BACKGROUND
  Germ cell tumours (GCTs) are rare, constituting 3% of all childhood malignancies. The aim of this study was to analyse the epidemiology and outcome of these patients.
  
  
  METHODS
  A retrospective, cohort study was conducted on 38 paediatric patients presenting with extracranial GCTs, treated at the Singapore General Hospital, Tan Tock Seng Hospital and Kandang Kerbau Women's and Children's Hospital from 1 January 1989 to 30 June 1999. The median age at diagnosis was 1.7 years (0 to 13 years).
  
  
  RESULTS
  There was no sex or racial preponderance. Eighteen patients (47.3%) had teratomas, 16 (42.1%) had yolk sac tumours, 1 (2.6%) had dysgerminoma and 3 (7.9%) had mixed GCTs. Thirty-four patients (89.5%) had Stage I disease, 1 (2.6%) had Stage II disease, 1 (2.6%) had Stage III disease and 2 (5.3%) had metastatic disease. Complete tumour resection was achieved in 36 of the 38 patients (95%). Cisplatin-based combination chemotherapy was given to 11 patients (28.9%). None of the patients received radiotherapy. Complications from chemotherapy included anaemia requiring packed red cell transfusion (n = 3), Port-a-cath sepsis requiring removal (n = 1), febrile neutropenia (n = 1) and nephropathy (n = 1).
  
  
  CONCLUSIONS
  Using the Kaplan-Meier life tables, the overall and event-free survivals at 10 years for the patients with malignant GCTs were 96% and 88%, respectively, with a mean follow-up period of 5.1 years (0.7 to 10 years). The majority of the patients presented with early Stage I disease and this contributed to our high survival rate.
authors.affiliation: Haematology/Oncology Service, Department of Paediatric Medicine, KK Women's & Children's Hospital, 100 Bukit Timah Road, Singapore 229899. lillianl@kkh.com.sg
authors.forename: L P N
authors.initials: LP
authors.lastname: Lim
authors.forename: A M
authors.initials: AM
authors.lastname: Tan
authors.forename: M Y
authors.initials: MY
authors.lastname: Chan
authors.forename: V
authors.initials: V
authors.lastname: Rajalingam
authors.forename: J
authors.initials: J
authors.lastname: Lou
authors.forename: C L
authors.initials: CL
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D018237:Germinoma / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology