Malignant extracranial germ cell tumours: A first national report by the South African Children's Cancer Study Group

Abstract

Objective: To determine the overall survival (OS) and prognostic factors influencing outcomes in children and adolescents with malignant extracranial germ cell tumours (MEGCTs) in preparation for the development of a harmonised national treatment protocol.Methods: A retrospective folder review was undertaken at nine South African paediatric oncology units to document patient profiles, tumour and treatment-related data and outcomes for all children with biopsy-proven MEGCTs from birth up to and including 16 years of age.

Socioeconomic status significantly impacts childhood cancer survival in South Africa

“…We were able to show a significant relationship between poverty and a lower survival outcome in a large and diagnostically heterogenous group of South African children with cancer, similar to the relationship previously reported in South African children with malignant extracranial germ cell tumours 23 . This was consistent with our first hypothesis that a significant relationship exists between SES and childhood cancer outcome in South Africa.…”

“…Since 2010, race as a demographic identifier was excluded from disease‐specific interrogations of large national retrospective datasets, 21–23 performed by the South African Association of Paediatric Haematology Oncology (SAAPHO), and rather substituted by indices of socioeconomic status (SES) like annual household income and maternal education level. A previous national South African report demonstrated a significant relationship between a lower risk of death and higher SES status in children with malignant extracranial germ cell tumours cancer (hazard ratio 0.071; p = .039) 23 .…”

“…Since 2010, race as a demographic identifier was excluded from disease‐specific interrogations of large national retrospective datasets, 21–23 performed by the South African Association of Paediatric Haematology Oncology (SAAPHO), and rather substituted by indices of socioeconomic status (SES) like annual household income and maternal education level. A previous national South African report demonstrated a significant relationship between a lower risk of death and higher SES status in children with malignant extracranial germ cell tumours cancer (hazard ratio 0.071; p = .039) 23 . To validate this finding in a larger, diagnostically more diverse cohort of patients, we analysed pooled data using combined, contemporaneous disease‐specific databases and hospital registries from institutions in the Gauteng province, which is the most densely populated and socioeconomically diverse region of the country.…”

Extracranial germ cell tumours: Mature and immature (1990–2015). First report by the South African Association of Paediatric Haematology Oncology (SAAPHO)

“…Given the trends seen in other related single-disease cohorts from South Africa, we recommend that it engages a discussion about formalising financial support for indigent families as a mandatory component to facilitate improved outcomes in economically vulnerable children. 19 We advise more vigorous advocacy at a national level by the South…”

“…Given the trends seen in other related single‐disease cohorts from South Africa, we recommend that it engages a discussion about formalising financial support for indigent families as a mandatory component to facilitate improved outcomes in economically vulnerable children 19 . We advise more vigorous advocacy at a national level by the South African Association of Paediatric Haematology Oncology (SAAPHO) with the support of invested and independently funded parent support organisations to support access to national treatment guidelines at accredited centres in both the public and private sectors, especially in support of children from the most vulnerable sections of our society.…”