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Treatment Options for Childhood Extracranial GCTs by Histological Type
Source: Childhood Extracranial Germ Cell Tumors Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: November 5, 2024 · Captured 2026-09-09.
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Context: Treatment Option Overview for Childhood Extracranial GCTs
Table 7 provides an overview of treatment options for children with extracranial GCTs. Specific details of treatment by primary site and clinical condition are described in subsequent sections.
Source links and citations
| Histology | Treatment Options | ||
|---|---|---|---|
| BEP = bleomycin (weekly), etoposide, and cisplatin; JEb = carboplatin, etoposide, and bleomycin; PEb = cisplatin, etoposide, and bleomycin (bleomycin only on day 1 of each cycle). | |||
| aChemotherapy has not been shown to be effective in the treatment of children with stages II–IV immature teratoma. However, the role of chemotherapy in these patients has not been systematically studied. In postpubertal patients, chemotherapy remains the standard treatment, although studies are limited.[2] | |||
| bIn prepubertal females with reported stage I disease, but in whom strict surgical staging guidelines were not followed, chemotherapy (PEb) can be considered standard treatment.[3] | |||
| cIn postpubertal females with stage I disease, the strategy of observation after surgery has not been established. This treatment strategy is under investigation in a clinical trial (AGCT1531 [NCT03067181]). | |||
| Mature teratoma | |||
| Sacrococcygeal site | Surgery and observation | ||
| Nonsacrococcygeal site | Surgery and observation | ||
| Immature teratoma | Surgery and observation (stage I) | ||
| Surgery and observation or chemotherapy (stages I–IV) a | |||
| Malignant gonadal GCTs in children: | |||
| Childhood malignant testicular GCTs: | |||
| Malignant testicular GCTs in prepubertal males | Surgery and observation (stage I) | ||
| Surgery and chemotherapy (PEb) (stages II–IV) | |||
| Malignant testicular GCTs in postpubertal males | For information, see Testicular Cancer Treatment. | ||
| Childhood malignant ovarian GCTs: | |||
| Dysgerminomas of the ovary | Surgery and observation (stage I) | ||
| Surgery and chemotherapy (PEb) (stages II–IV) | |||
| Malignant nongerminomatous ovarian GCTs (yolk sac and mixed GCTs) in prepubertal females | Surgery and observation for prepubertal females (stage I following strict surgical staging guidelines) b. For information about the treatment of ovarian mature teratoma, see the Childhood Malignant Ovarian GCTs section. | ||
| Surgery and chemotherapy (PEb) for prepubertal and postpubertal females (purported stage I and stages II–IV) | |||
| Malignant nongerminomatous ovarian GCTs (yolk sac and mixed GCTs) in postpubertal females | Surgery and chemotherapy (BEP) for prepubertal and postpubertal females (purported stage I and stages II–IV) c | ||
| Malignant nongerminomatous ovarian GCTs (yolk sac and mixed GCTs) that are initially unresectable | Biopsy followed by chemotherapy and surgery (initially unresectable ovarian GCT) | ||
| Malignant extragonadal extracranial GCTs in children: | |||
| Malignant extragonadal extracranial GCTs in prepubertal children | Surgery and chemotherapy (PEb or JEb) (stages I –IV) | ||
| Biopsy followed by chemotherapy with or without surgery (stages III and IV) | |||
| Malignant extragonadal extracranial GCTs in postpubertal children | Surgery | ||
| Chemotherapy (BEP) | |||
| Chemotherapy followed by surgery to remove residual tumor | |||
| Enrollment in a clinical trial | |||
| Recurrent malignant GCTs in children | Surgery alone | ||
| Surgery with neoadjuvant or adjuvant chemotherapy | |||
Source links and citations
- 2
- 3
- AGCT1531 [NCT03067181]
- Surgery and observation
- Surgery and observation
- Surgery and observation (stage I)
- Surgery and observation or chemotherapy (stages I–IV)
- Surgery and observation (stage I)
- Surgery and chemotherapy (PEb) (stages II–IV)
- Testicular Cancer Treatment
- Surgery and observation (stage I)
- Surgery and chemotherapy (PEb) (stages II–IV)
- Surgery and observation for prepubertal females (stage I following strict surgical staging guidelines)
- Childhood Malignant Ovarian GCTs
- Surgery and chemotherapy (PEb) for prepubertal and postpubertal females (purported stage I and stages II–IV)
- Surgery and chemotherapy (BEP) for prepubertal and postpubertal females (purported stage I and stages II–IV)
- Biopsy followed by chemotherapy and surgery (initially unresectable ovarian GCT)
- Surgery and chemotherapy (PEb or JEb) (stages I –IV)
- Biopsy followed by chemotherapy with or without surgery (stages III and IV)
- Surgery
- Chemotherapy (BEP)
- Chemotherapy followed by surgery to remove residual tumor
- Enrollment in a clinical trial
- Surgery alone
- Surgery with neoadjuvant or adjuvant chemotherapy
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