Germ cell tumours (GCTs) are rare but clinically and pathologically diverse tumours that occur in an extensive range of age groups, from children to older adults and which include both seminomatous and nonseminomatous tumours. Current clinical management for both male and female teenagers and young adults (TYAs) with GCTs remains inconsistent, alternating between paediatric and adult multidisciplinary oncology teams, based on locally defined age cut-offs. We therefore reviewed available literature to determine the biological similarities and differences between GCTs in young children [0-12 years (y)], TYAs (13-24y), and older adults (>24y). GCTs arising in paediatric and adult populations in general showed marked molecular biological differences within identical histological subtypes, whereas there was a distinct paucity of available data for GCTs in the TYA population. These findings highlight that clinical management based simply on chronological age may be inappropriate for TYA and suggests that the optimal future management of GCTs should consider specific molecular biological factors in addition to clinical parameters in the context of patient specific age group specialty.
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AimsThe aim of this review was to analyse molecular biological studies of germ cell tumours (GCTs) arising in the paediatric (≤12y) and older adult (>24y) age groups for key similarities and differences in an attempt to identify where the biology of GCTs from teenagers and young adult (TYA) patients lies within this framework. The review discusses current knowledge in this area and also highlights gaps that still need to be addressed. In the UK, the TYA age group includes male and females aged 13-24y; accordingly we have used this definition for the purposes of this review).The aims were achieved through a synthesis and analysis of available biological data for GCTs in children, TYAs and older adults. We anticipated that the goal would be to use a combination of both clinical and biological risk factors to improve clinical management decisions for TYA patients with GCTs (Murray et al., 2009).
