Pediatric and Adolescent Extracranial Germ Cell Tumors: The Road to Collaboration

摘要: During the past 35 years, survival rates for children with extracranial malignant germ cell tumors (GCTs) have increased significantly. Success has been achieved primarily through application of platinum-based chemotherapy regimens; however, clinical challenges in GCTs remain. Excellent outcomes are not distributed uniformly across heterogeneous distribution age, histologic features, and primary tumor site. Despite good overall, likelihood a cure certain sites conditions is less than 50%. In addition, there considerable long-term treatment-related effects survivors. Even modest cisplatin dosing can cause significant morbidities. A particular challenge designing new therapies GCT that variety specialists use different risk stratifications, staging systems, treatment approaches three distinct age groups (childhood, adolescence, young adulthood). Traditionally, pediatric cancer patients younger 15 years treated by oncologists collaboration their surgical specialty colleagues. Adolescents adults often medical oncologists, urologists, or gynecologic oncologists. The therapeutic dilemma all how to best define disease so therapy toxicity be appropriately reduced some intensified others. Further biologic insights only collaborations do set limitations sex, Therefore, international collaborations, spanning cooperative disciplines, developed address these challenges.