Survival difference among adult and pediatric mediastinal yolk sac tumors cases : A meta-analysis of case reports
© 2024 Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved..
BACKGROUND: Mediastinal Yolk sac tumors (YST) are rare and highly malignant extragonadal germ cell tumors with rapid growth and early metastases. We sought to conduct a meta-analysis of published case reports/case series to compare differences in survival, demographics, and treatment modalities between adult and pediatric patients with YST.
METHODS: Ovid Embase, Cochrane, and Ovid Medline databases were searched for primary mediastinal pure YST cases. The primary outcome was overall survival (OS). Log-rank and Cox regression were used. This study is registered on PROSPERO (CRD42022367586).
RESULTS: Among 846 studies, 87 met our inclusion criteria including 130 patients (Adults: 90 and Pediatrics: 40). About 41.5% of the patients were from the United States. The median age was 23.0 (Q1-Q3: 17.0-30.0), 88.5% were males, and (32.3%) were Asian. Stage II represented almost 40%. AFP was elevated in 96.9%. Respiratory distress was the presenting symptom in 65.4%. Chemotherapy, radiotherapy, and surgery were utilized in 84.6, 23.1, and 64.7% respectively. Median OS was 24 months (Adults: 23 months, Pediatrics: 25 months, P = 0.89). 3- and 5-year OS were 34.4% and 22.9% in adults and 41.5% and 41.5% in pediatrics, respectively. On multivariate analysis, anterior location of tumors, receipt of chemotherapy, and undergoing surgery were associated with better OS.
CONCLUSION: Primary mediastinal YSTs are rare, but lethal neoplasms. Our meta-analysis showed that mediastinal YSTs mimic other non-seminomatous mediastinal GCTs in terms of clinical characteristics and available treatment options. Early diagnosis, neoadjuvant chemotherapy, and surgical resection are the key points for effective management and improved outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology - 50(2024), 3 vom: 30. März, Seite 108019 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Dabsha, Anas [VerfasserIn] |
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| Links: |
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| Themen: |
Adults yolk sac |
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| Anmerkungen: |
Date Completed 11.03.2024 Date Revised 11.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ejso.2024.108019 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368498115 |
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| 100 | 1 | |a Dabsha, Anas |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Survival difference among adult and pediatric mediastinal yolk sac tumors cases |b A meta-analysis of case reports |
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| 500 | |a Date Revised 11.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved. | ||
| 520 | |a BACKGROUND: Mediastinal Yolk sac tumors (YST) are rare and highly malignant extragonadal germ cell tumors with rapid growth and early metastases. We sought to conduct a meta-analysis of published case reports/case series to compare differences in survival, demographics, and treatment modalities between adult and pediatric patients with YST | ||
| 520 | |a METHODS: Ovid Embase, Cochrane, and Ovid Medline databases were searched for primary mediastinal pure YST cases. The primary outcome was overall survival (OS). Log-rank and Cox regression were used. This study is registered on PROSPERO (CRD42022367586) | ||
| 520 | |a RESULTS: Among 846 studies, 87 met our inclusion criteria including 130 patients (Adults: 90 and Pediatrics: 40). About 41.5% of the patients were from the United States. The median age was 23.0 (Q1-Q3: 17.0-30.0), 88.5% were males, and (32.3%) were Asian. Stage II represented almost 40%. AFP was elevated in 96.9%. Respiratory distress was the presenting symptom in 65.4%. Chemotherapy, radiotherapy, and surgery were utilized in 84.6, 23.1, and 64.7% respectively. Median OS was 24 months (Adults: 23 months, Pediatrics: 25 months, P = 0.89). 3- and 5-year OS were 34.4% and 22.9% in adults and 41.5% and 41.5% in pediatrics, respectively. On multivariate analysis, anterior location of tumors, receipt of chemotherapy, and undergoing surgery were associated with better OS | ||
| 520 | |a CONCLUSION: Primary mediastinal YSTs are rare, but lethal neoplasms. Our meta-analysis showed that mediastinal YSTs mimic other non-seminomatous mediastinal GCTs in terms of clinical characteristics and available treatment options. Early diagnosis, neoadjuvant chemotherapy, and surgical resection are the key points for effective management and improved outcomes | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Adults yolk sac | |
| 650 | 4 | |a Mediastinal | |
| 650 | 4 | |a Meta-analysis | |
| 650 | 4 | |a Pediatrics yolk sac | |
| 650 | 4 | |a Yolk sac tumor | |
| 700 | 1 | |a Elkharbotly, Ismail A M H |e verfasserin |4 aut | |
| 700 | 1 | |a Yaghmour, Mohammad |e verfasserin |4 aut | |
| 700 | 1 | |a Badr, Amr |e verfasserin |4 aut | |
| 700 | 1 | |a Badie, Fady |e verfasserin |4 aut | |
| 700 | 1 | |a Khairallah, Sherif |e verfasserin |4 aut | |
| 700 | 1 | |a Esmail, Yomna M |e verfasserin |4 aut | |
| 700 | 1 | |a Hossny, Mohamed |e verfasserin |4 aut | |
| 700 | 1 | |a Rizk, Amr |e verfasserin |4 aut | |
| 700 | 1 | |a El-Demiry, Amr |e verfasserin |4 aut | |
| 700 | 1 | |a Ghaly, Galal |e verfasserin |4 aut | |
| 700 | 1 | |a Al-Thani, Shaikha |e verfasserin |4 aut | |
| 700 | 1 | |a Demetres, Michelle |e verfasserin |4 aut | |
| 700 | 1 | |a Mohamed, Abdelrahman |e verfasserin |4 aut | |
| 700 | 1 | |a Villena-Vargas, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Kamal, Mona |e verfasserin |4 aut | |
| 700 | 1 | |a Rahouma, Mohamed |e verfasserin |4 aut | |
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