한국 소아 고환종양 등록현황: 1997-2001

Abstract

Purpose: The rare incidence of pediatric testicular tumors makes it difficult for any single institution to gain enough information about the tumor’s biological behavior. To date, there are no multi-institutional reports on pediatric testicular tumors in Korea. Our study was undertaken to obtain the valuable demographic data for the better understanding of the biological behavior and optimal management for these tumors. Materials and Methods: A pediatric testicular tumor registry form was mailed to all 87 hospitals registered in the Korean Urology Association. 249 medical records that were five years old were retrospectively reviewed, with the exception of 15 which had no histopathologic records. Results: According to the 249 patients who were enrolled in this registry, the incidence was 0.65 per 100,000 children. The distribution of age ranged from 1 to 240 months (mean 57.6). Most of the patients were diagnosed with a scrotal mass before the age of 4. Serum AFP and beta-hCG increased to as much as 64.1% (92.9% in yolk sac tumor, 32.9% in teratoma) and 13.1% (5.3% in yolk sac tumor, 5.0% in teratoma) of patients, respectively. Preoperative diagnosis was featured as malignant tumors (67.9%), benign tumors (20.9%), and hydrocele (5.2%). Germ cell tumors were the most common (88.7%) mainly with either the yolk sac tumor (41.8%) or teratoma (35.7%). Primary management was as follows: radical (96%), simple (3.6%), and partial orchiectomy (0.4%). Management after surgery included: 64.3% surveillance, 12.4% chemotherapy, 4% combination therapy, and 19.3% other methods. The metastasis rate, as a whole, was 16.8% (18.3% in yolk sac tumor, 2.2% in teratoma). The final results of the treatment were as follows: complete remission (63.9%), incomplete remission (4.4%), no response or disease progression (1.2%), and unknown (30.5%). Outcomes at the last follow up (mean of 24.5 months) were 75.9% alive, 0.8% deceased, and 23.3% unknown status. Conclusions: The demographic data of pediatric testicular tumors in Korea will lead to a better understanding of these rare tumors and to the development of an optimal therapy for these children