Clinicopathological patterns and treatment outcomes of pediatric germ cell tumors treated at Tikur Anbessa Specialized Hospital, Ethiopia: a single tertiary hospital experience.
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BACKGROUND: Pediatric germ cell tumors (GCTs) are rare, heterogeneous neoplasms with peak incidence in children under 4 years of age and during adolescence. The clinical presentation and treatment outcomes of GCTs are not well-studied in developing countries. This study aimed to assess the clinicopathological patterns and treatment outcomes of pediatric GCT patients treated at the largest tertiary referral hospital in Ethiopia. METHODS: A retrospective cross-sectional study was conducted at Tikur Anbessa Specialized Hospital, Ethiopia, on pediatric GCT patients treated between January 1, 2013, and December 31, 2023. Data were collected and analyzed using SPSS version 25. The Kaplan-Meier survival estimate was employed to evaluate Overall Survival (OS) and Event-Free Survival (EFS). The log-rank test was used to compare Kaplan-Meier curves, P < 0.05 was considered to indicate a statistically significance. RESULTS: A total of 91 patients were included in the study. The median age at diagnosis was 4 years, with a predominance of females. Children under 5 years of age constituted 61.6% (n = 56) of the cases. Sacrococcygeal swelling was the most common presenting symptom, accounting for 38.2% (n = 34), followed by abdominal mass accounted for 36%. Most patients (93.4%, n = 85) had extra-cranial GCTs, with mature teratoma being the most prevalent histological subtype (52.6%). Approximately 42.5% of patients received a combination of chemotherapy and local control measures, primarily surgery. Kaplan-Meier survival analysis revealed that the 1-year and 5-year OS rates were 92.7% and 85%, respectively, while the 1-year and 5-year EFS rates were 95% and 84%, respectively. CONCLUSION: This study demonstrated that the median age at diagnosis for pediatric GCTs was 4 years, with a female predominance. Mature teratoma was the most frequent histological subtype. The observed 1-year and 5-year OS rates were comparable to other studies conducted in similar setting in low- and middle-income countries.