Pediatric Neurosurgery
Therapeutic strategies and outcomes of intracranial immature teratoma with negative serum tumor markers
Huang Xiang, Zhang Chao, Wang Yang, Wang Enmin, Zhang Rong
Published 2020-09-28
Cite as Chin J Neurosurg, 2020, 36(9): 891-895. DOI: 10.3760/cma.j.cn112050-20200408-00223
Abstract
ObjectiveTo investigate the therapeutic strategies and prognosis of intracranial immature teratomas with negative serum tumor markers including alpha fetoprotein (AFP) and beta human chorionic gonadotropin (β-hCG).
MethodsWe retrospectively analyzed the clinical data of 23 intracranial immature teratoma patients with negative preoperative serum tumor markers (AFP and β-hCG) who were admitted to Department of Neurosurgery, Huashan Hospital, Fudan University from January 1997 to December 2019. All patients underwent surgery to remove the tumor. Among them, postoperative radiotherapy (merely conventional radiotherapy in 10, conventional radiotherapy combined with gamma knife therapy in 7, and merely gamma knife therapy in 1) was performed in 18 patients and chemotherapy in 10. Kaplan-Meier method and log-rank test were used for survival analysis and comparison.
ResultsOf the 23 patients, 16 underwent total resection, 4 had subtotal resection, and 3 had partial resection. Postoperative pathological results indicated 19 cases of immature teratoma and 4 cases of mixed germ cell tumor containing immature teratoma components. Of the 23 patients, 2 were lost to follow-up and 21 were followed up. The 5-year and 10-year survival rates of 23 patients were 71.7% and 65.7%, respectively. Lag-rank analysis results showed that postoperative radiotherapy and chemotherapy were not influencing factors for the survival rate of patients (both P>0.05). Among the 16 patients with residual tumors or recurrent tumors after surgery, the 5-year survival rates of those undergoing gamma knife treatment (8 cases) and those without gamma knife treatment (8 cases) were 100.0% and 28.6% respectively (P=0.01).
ConclusionsAs for intracranial immature teratoma with negative preoperative serum tumor markers, surgical treatment should be preferred and total resection should be achieved as far as possible. Timely treatment using Gamma knife could be an effective complementary therapy for postoperative residual or recurrent tumor, which could lead to a relatively long survival.
Key words:
Teratoma; Neurosurgical procedures; Prognosis; Gamma knife radiosurgery; Tumor markers, biological
Contributor Information
Huang Xiang
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
Institute of Neurosurgery, Fudan University, Shanghai 201107, China
Zhang Chao
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
Institute of Neurosurgery, Fudan University, Shanghai 201107, China
Wang Yang
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
Institute of Neurosurgery, Fudan University, Shanghai 201107, China
Wang Enmin
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
Institute of Neurosurgery, Fudan University, Shanghai 201107, China
Zhang Rong
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
Institute of Neurosurgery, Fudan University, Shanghai 201107, China
