title: Testicular germ cell tumors in adolescents - results of the protocol MAHO 98 and the identification of good risk patients.
abstract: BACKGROUND
  In adolescents aged 10-15 years germ cell tumors of the testis (TGCT) are rare and information for a risk adapted therapy limited.
  
  
  OBJECTIVE
  The protocol MAHO 98 for patients (pts) with TGCTs is stratified according to age, stage and histology. Pts ≥ 10 years received after tumororchiectomy 2 courses (crs) PVB and restaging. Residual tumor was resected and therapy continued in regard to inital stage and response. Chemotherapy: PVB: cisplatin (20 mg/m²/day 1-5), vinblastine (3 mg/m²/day 1+2), and bleomycin (15 U/m²/day 1-3). For consolidation 1 crs PVB has been given to stage II patients with CR. In case of PR, 2 crs PEB (vinblastine substituted by etoposide 100 mg/m²/day 1-3) or relapse 3 crs PEI (bleomycin substituted by ifosfamide 1 500 mg/m²/day 1-5) were given.
  
  
  RESULTS
  Between Jan 1998 and Dec 2005, 34 pts (≥ 10 year) were registered, 31 fulfilled the inclusion criteria. Median age: 15;6 years; months (range 13;5-20;2 ). Lugano staging: IA n=14, IB n=2, IC n=3, IIA n=4, IIB n=6, IIC n=1, IIIC n=1. The stage IIIC pt received preoperative chemotherapy, all other pts had tumororchiectomy first. Residual tumor after 2 crs PVB was detected in 4 pts and was resected. Late relapses occurred in 2 pts and were cured by additional therapy. All patients are surviving.
  
  
  CONCLUSIONS
  Young patients with TGCT stage I and II have an excellent prognosis and further reduction of therapy has to be considered.
authors.affiliation: Pediatric Oncology and Hematology, University Düsseldorf, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Göbel
authors.affiliation: Pediatric Hematology and Oncology, University Münster, Münster, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Calaminus
authors.affiliation: Pediatric Hematology and Oncology, Ludwig-Maximilians-University -Munich, Munich, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Haas
authors.affiliation: Pediatric Hematology and Oncology, University Münster, Münster, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Teske
authors.affiliation: Pediatric Hematology and Oncology, University of Bonn, Bonn, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schönberger
authors.affiliation: Clinic for Pediatrics, Municipal Hospital, Dortmund, Germany.
authors.forename: D T
authors.initials: DT
authors.lastname: Schneider
authors.affiliation: Kiel Paediatric Tumor Registry, Dept. of Paediatric Pathology, University of Kiel, Kiel, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Leuschner
authors.affiliation: Kiel Paediatric Tumor Registry, Dept. of Paediatric Pathology, University of Kiel, Kiel, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Harms
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D009919:Orchiectomy; D011379:Prognosis; D020379:Risk Adjustment; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014747:Vinblastine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D001761:Bleomycin; D014747:Vinblastine; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide; D008727:Methotrexate