Clinical analysis of management of pediatric testicular germ cell tumors.
OBJECTIVE
To analyze our experiences of pediatric testicular tumors and investigate the management of pediatric testicular germ cell tumors. Pediatric testicular tumors are rare and the treatment of them has not been well defined.


METHODS
Children treated for primary testicular tumors between January 1998 and July 2010 were retrospectively analyzed. For yolk sac tumor, the difference of survival rates between patients with and without retroperitoneal lymph node dissection (RPLND) was calculated.


RESULTS
Eighty-seven cases met our criteria and 78 were germ cell tumors, including 40 cases with yolk sac tumor. Patients were 3-128 months old (median 19), and 53 patients were diagnosed at younger than 2 years of age. For germ cell tumors, serum α-fetoprotein and β-human chorionic gonadotropin were elevated in 48 and 7 patients, respectively, including 38 and 2 in those with yolk sac tumor. RPLND and chemotherapy were performed in 13 and 19 patients, respectively, and surveillance was performed in 50 patients. With median follow-up of 50 months, 6 patients had recurrence, 4 patients died, and the others achieved complete remission. For stage I yolk sac tumor, the difference of survival rates between patients with and without RPLND was not significant (P = .808).


CONCLUSIONS
Yolk sac tumor is the most common type of pediatric testicular tumor. For stage I yolk sac tumor, radical inguinal orchiectomy is effective, salvage chemotherapy is promising, and RPLND may not be necessary.
Department of Urology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Yun-Lin
YL
Ye
Xiang-Zhou
XZ
Sun
Fu-Fu
FF
Zheng
Jun
J
Bian
Yan-Ping
YP
Huang
Xue-Qi
XQ
Zhang
Zhi-Xun
ZX
Li
Ying
Y
Nie
Zi-Ke
ZK
Qin
Yu-Ping
YP
Dai
D000293:Adolescent; D000314:Adrenal Rest Tumor / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D006063:Chorionic Gonadotropin / Q000097:blood; D018240:Endodermal Sinus Tumor / Q000628:therapy; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D007984:Leydig Cell Tumor / Q000628:therapy; D008197:Lymph Node Excision; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D009919:Orchiectomy; D018233:Rhabdomyosarcoma, Embryonal / Q000628:therapy; D013736:Testicular Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D000509:alpha-Fetoproteins / Q000032:analysis
D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins