Surgical Treatment and Outcome of Extracranial Germ Cell Tumors in Childhood

Germ cell tumors (GCTs) are a heterogeneous group of very rare tumors, benign or malignant, which can occur from newborn to old age. They are thought to arise from primordial germ cells, and are found in a variety of sites. This thesis is composed of 2 major parts. In a first part, the hospital records of 193 infants and children with GCTs, treated between 1960 and 2003 in ErasmusMC-Sophia Children’s Hospital Rotterdam and between 1986 and 2003 in the Academic Hospital of the Free University of Brussels, are studied. The long-term outcome for the various anatomical sites and histologies, is studied. Pitfalls in diagnosis and treatment are reported. A second part of the thesis is devoted to the study of (a) 173 patients with sacrococcygeal teratoma, treated between 1970 and 2003 in the six centers of pediatric surgery in the Netherlands, and of (b) 70 patients with SCT treated between 1960 and 2003 in ErasmusMC-Sophia Children’s Hospital Rotterdam. In these patient populations, risk factors for recurrence are studied, as well as functional results and quality of life. Subject headings: 1. Introduction 2. Influence of Tumor Site and Histology on Long-Term Survival in 193 Children with Extracranial Germ Cell Tumors Treated between 1960 - 2003 3. Ovarian Germ Cell Tumors in Children: A Clinical Study of 66 Patients 4. Testicular Germ Cell Tumors in Children: Management and Outcome in a Series of 20 Patients 5. Strategy for Management of Newborns with Cervical Teratoma 6. Mediastinal Germ Cell Tumors: Clinical Aspects and Outcomes in 7 Children 7. Retroperitoneal Germ Cell Tumors: A Clinical Study of 12 Patients 8. Study of the Factors Associated with Recurrence in Children with Sacrococcygeal Teratoma 9. Factors Associated with Recurrence and Metastatic Disease in Sacrococcygeal Teratoma: Results in the Netherlands (1970-2003) 10. Sacrococcygeal Teratoma: Results of a Retrospective Multicentric Study in Belgium and Luxembourg 11. Long-Term Functional Sequelae of Sacrococcygeal Teratoma: A National Study in the Netherlands 12. General Discussion

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