Clinical characteristics and prognoses of yolk sac tumor:a report of 85 children
Objective To explore the clinical characteristics and prognostic factors of yolk sac tumor(YST)in children.Methods From January 2010 to August 2018,clinical characteristics,treatments and prognoses were retrospectively reviewed for 85 YST children.Survival curve was plotted by Kaplan-Meier method.Univariate and multivariate Cox proportional hazard regression models were utilized for examining the prognostic factors.Results Median age was 20.5(0.03-166.6)months,median follow-up period 62.1(1.5-133.1)months,5-year overall survival(OS)87.1％(95％CI:79.7％-94.5％)and 5-year progression-free survival(PFS)79.8％(95％CI:70.6％-89.0％).Univariate Cox regression analysis indicated that residing region,delay of adjuvant chemotherapy(DAC),preoperative alpha-fetoprotein(AFP),AFP not normalized within 2 months postoperatively and tumor recurrence were risk factors affecting the OS of YST children.Multivariate Cox regression analysis revealed that rural residing(HR=7.830,95％CI:1.60-38.41,P=0.011),DAC(HR=5.323,95％CI:1.14-25.64,P=0.047),AFP not normalized within 2 months postoperatively(HR=15.704,95％CI:1.65-149.18,P=0.017)and tumor recurrence(HE=26.046,95％CI:3.03-224.07,P=0.003)were independent risk factors for prognosis.Conclusion Rural residing,DAC,AFP not normalized within 2 months postoperatively and tumor recurrence hint at a poor prognosis.Clinicians should individualize treatments and conduct regular follow-ups of imaging for YST children according to residing region,intent of chemotherapy and level of AFP.
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