ArticleAnnals of surgical oncology2026
Challenges in Managing Primary Retroperitoneal Germ Cell Tumors in Children: The Role of Neoadjuvant Chemotherapy.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrimary retroperitoneal germ cell tumors (GCTs) are rare and often present as large masses with close anatomical relationships to adjacent organs and vessels, which can complicate surgical management. Indications for neoadjuvant chemotherapy are guided by pathological features and serum alpha-fetoprotein (AFP) levels; however, these levels may be difficult to interpret in infants. While some tumors respond to neoadjuvant chemotherapy, others may progress during treatment, making surgical resection even more challenging. This study aimed to evaluate the management and outcomes of retroperitoneal GCTs within a national multicenter cohort. PATIENTS AND
methodsThis national retrospective study included pediatric patients with primary retroperitoneal GCTs who underwent surgical resection between 2000 and 2022. Data were identified through the French Very Rare Tumors Committee (FRACTURE) database, the TGM-2013 study, and the Groupe des Chirurgiens Pédiatres Opérant des Tumeurs (GCPOT) collaborative group.
resultsA total of 24 children were included (17 girls). The median age and weight at diagnosis were 5.2 months (range 1.6-44 months) and 7.4 kg (range 4-14 kg), respectively. Five patients (29%) had a prenatal diagnosis. The median tumor volume was 563 cm
conclusionsThis study confirms the favorable oncological prognosis of primary retroperitoneal GCTs in children. Neoadjuvant chemotherapy should be approached with caution, as its impact on tumor volume may be limited. Furthermore, it carries a potential risk of growing teratoma syndrome, which can ultimately lead to even more challenging surgical procedures.
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