Intracranial Germ Cell Tumors in Adolescents and Young Adults: A 40-Year Multi-Institutional Review of Outcomes

Lo, Andrea; Hodgson, David C.; Dang, Jennifer; Tyldesley, Scott; Bouffet, Éric; Bartels, Ute; Cheng, Sylvia; Hukin, Juliette; Bedard, Philippe L.; Goddard, Karen; Laperrière, Normand

doi:10.1016/j.ijrobp.2019.10.020

Cited by 45 publications

(30 citation statements)

References 20 publications

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“…A large retrospective study specifically focused on adolescence and young adults (15‐39 years) demonstrated that outcomes are excellent overall, although higher relapse and inferior survival rates were observed after non‐craniospinal radiotherapy without chemotherapy for germinomas 71 …”

Section: Suprasellar Germinomamentioning

confidence: 99%

A clinical approach to parasellar lesions in the transition age

Sbardella

Puliani

Feola

et al. 2021

J Neuroendocrinology

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Many reviews have summarised the pathology and management of the parasellar region in adult patients, although an analysis of these aspects in the transition years, from puberty onset to the age of peak bone mass, has been lacking. A comprehensive search of English‐language original articles, published from 2000 to 2020, was conducted in the MEDLINE database (December 2019 to March 2020). We selected all studies regarding epidemiology, diagnosis and management of the following parasellar lesions: germinoma, craniopharyngioma, Langerhans cell histiocytosis, optic glioma, hypothalamic hamartoma, tuber cinereum hamartoma, cranial chordoma, Rathke cleft cyst, hypophysitis and hypothalamitis during the transition age from childhood to adulthood. In the present review, we provide an overview of the principal parasellar lesions occurring in the transition age. Symptoms are usually a result of the mass effect of the lesions on nearby structures, as well as anterior pituitary deficits. Diabetes insipidus occurs frequently in these patients. In this age group, pubertal developmental disorders may be more evident compared to other stages of life. Parasellar lesions in the transition age mostly include neoplastic lesions such as germinomas, hamartomas, optic gliomas, craniopharyngiomas Langerhans cell histiocytosis and chordomas, and rarely inflammatory lesions (hypophysitis, hypothalamitis). There are limited data on the management of parasellar lesions in the transition age. Endocrine evaluation is crucial for identifying conditions that require hormonal treatment so that they can be treated early to improve the quality of life of the individual patient in this complex age range. The clinical approach to parasellar lesions involves a multidisciplinary effort.

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Section: Suprasellar Germinomamentioning

confidence: 99%

A clinical approach to parasellar lesions in the transition age

Sbardella

Puliani

Feola

et al. 2021

J Neuroendocrinology

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“… 17 These differences might be attributed to the type of tumor, as the former study included only medulloblastoma or primitive neuroectodermal tumors, 18 whereas the latter had various types of pediatric CNS tumors including ependymomas, choroid plexus tumors, atypical teratoid rhabdoid tumors, astrocytic or oligodendroglial tumors, and GCTs, in addition to medulloblastoma or primitive neuroectodermal tumors. 17 Positive CSF cytology and presence of spinal lesions are rare events with incidences of 1.1%–8.9% and 0%–6.3% in germinoma, respectively, 2 , 9–11 , 19–21 so few reports have discussed the incidence of spinal disease in patients with positive cytology in GCTs. A previous case series analyzed the correlations between CSF cytology and spinal lesion.…”

Section: Discussionmentioning

confidence: 99%

Necessity for craniospinal irradiation of germinoma with positive cytology without spinal lesion on MR imaging—A controversy

Kanamori

Takami

Suzuki

et al. 2021

Neuro-Oncology Advances

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Background Cerebrospinal fluid (CSF) cytology and spinal MR imaging are routinely performed for staging before treatment of intracranial germinoma. However, the interpretation of the results of CSF cytology poses two unresolved clinical questions: 1) Does positive CSF cytology correlate with the presence of spinal lesion before treatment?; and 2) Is craniospinal irradiation (CSI) necessary for patients with positive CSF cytology in the absence of spinal lesion? Methods Multicenter retrospective analyses were performed based on a questionnaire on clinical features, spinal MR imaging finding, results of CSF cytology, treatments, and outcomes which was sent to 86 neurosurgical and 35 pediatrics departments in Japan. Pretreatment frequencies of spinal lesion on MR imaging were compared between the patients with positive and negative cytology. Progression-free survival (PFS) rates were compared between patients with positive CSF cytology without spinal lesion on MR imaging treated with CSI and with whole brain or whole ventricular irradiation (non-CSI). Results A total of 92 germinoma patients from 45 institutes were evaluated by both CSF cytology and spinal MR images, but 26 patients were excluded because of tumor markers, the timing of CSF sampling or incomplete estimation of spinal lesion. Of the remaining 66 germinoma patients, spinal lesions were equally identified in patients with negative CSF cytology and positive cytology (4.9% and 8.0%, respectively). 11 patients treated with non-CSI had excellent PFS comparable to 11 patients treated with CSI. Conclusion CSI is unnecessary for germinoma patients with positive CSF cytology without spinal lesions on MR imaging.

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“…It was reported that more than 90% of patients with intracranial germinomas were cured with CSI, and the long-term OS was from 90% to 100% after RT alone with a total cranial dose of 40–50 Gy ( 22 ). CT was considered an effective way to reduce the dose and volume of RT without weakening the survival rates ( 2 , 19 , 21 , 23 , 24 ). CT alone was not recommended for its significantly inferior outcomes in patients with intracranial GCTs compared with CT combined with RT ( 21 , 23 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

“…For patients with spinal dissemination, craniospinal irradiation was required. In terms of NGGCTs, multidisciplinary therapy, including tumor resection, radiation, and CT, was established ( 2 , 19 , 24 , 27 ). Patients with BGGCTs displayed significantly worse intelligent performance and health-related quality of life than those with tumors in sellar and pineal regions ( 26 , 28 ).…”

Section: Discussionmentioning

confidence: 99%

Basal Ganglia Germ Cell Tumors With or Without Sellar Involvement: A Long-Term Follow-Up in a Single Medical Center and a Systematic Literature Review

Zhang

Wang

et al. 2021

Front. Endocrinol.

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BackgroundBasal ganglia germ cell tumors (BGGCTs) represent an extremely rare subset of tumors about which little is known. Some patients suffer from tumor dissemination, such as sellar involvement. This study aimed to evaluate the independent prognostic risk factors of patients with BGGCTs with or without sellar involvement.MethodsSixteen patients were diagnosed with BGGCTs at Peking Union Medical College Hospital from January 2000 to December 2020. A literature review was performed on the online databases Medline and PubMed, and 76 cases in the 19 retrieved articles were identified at the same time. The data regarding biochemical tests, radiological examinations, and outcomes during follow-up were analyzed.ResultsOf 92 patients in this study, seven patients were clinically diagnosed as germinomas, with the remaining 85 patients receiving surgery. Fifty-two patients suffered from multifocal lesions or tumor dissemination. The patients with BGGCTs demonstrated a significant male predilection. The patients with delayed diagnosis more likely had cognitive disturbance (p = 0.028), mental disturbance (p = 0.047), and diabetes insipidus (p = 0.02). Multivariate analysis demonstrated that the independent poor prognostic risk factors of patients with BGGCTs were delayed diagnosis [odd ratio (OR) 2.33; 95% CI 1.02–5.31], focal radiotherapy (OR 4.00; 95% CI 1.69–9.49), and non-pure germinoma (OR 4.64; 95% CI 1.76–12.22).ConclusionsThe delayed diagnosis, focal radiotherapy, and non-pure germinoma were associated with a poorer prognosis for patients with BGGCTs with or without sellar involvement.

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Intracranial Germ Cell Tumors in Adolescents and Young Adults: A 40-Year Multi-Institutional Review of Outcomes

Cited by 45 publications

References 20 publications

A clinical approach to parasellar lesions in the transition age

A clinical approach to parasellar lesions in the transition age

Necessity for craniospinal irradiation of germinoma with positive cytology without spinal lesion on MR imaging—A controversy

Basal Ganglia Germ Cell Tumors With or Without Sellar Involvement: A Long-Term Follow-Up in a Single Medical Center and a Systematic Literature Review

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