{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T22:06:45Z","timestamp":1764194805824,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Vaginal malignant germ cell tumors (MGCT) are rare, occurring in children less than 2\u00a0years old and raise the question of the optimal local treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included children treated for vaginal MGCT according to the French TGM\u201095\/2013 regimen. Patients were classified as standard risk (SR: localized disease and alpha\u2010fetoprotein (AFP)\u00a0&lt;\u00a010,000\u00a0ng\/mL) or high risk (HiR: metastatic and\/or AFP\u00a0&gt;\u00a010,000\u00a0ng\/mL) and were treated, respectively, with three to five VBP (vinblastine\u2013bleomycin\u2013cisplatin) or four to six VIP (etoposide\u2013ifosfamide\u2013cisplatin), followed by conservative surgery and\/or brachytherapy in case of post\u2010chemotherapy residuum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen patients were included (median age\u00a0=\u00a012\u00a0months), of which six (43%) were classified as HiR. AFP levels were normalized after first\u2010line chemotherapy in all cases but one. A vaginal post\u2010chemotherapy residuum (median size\u00a0=\u00a08\u00a0mm, range: 1\u201324\u00a0mm) was observed in 13\/14 patients, treated by complete resection in seven of 13 (viable cells in three of seven), incomplete resection in four of 13 (viable cells in two of four), with adjuvant brachytherapy in two of 13, and exclusive brachytherapy in two of 13 (viable cells in one of six). Among the six patients with viable disease, four patients received adjuvant chemotherapy. One patient (SR) experienced immediate postoperative relapse despite presenting no viable residual cells and was treated with four VIP cycles and brachytherapy. At last follow\u2010up (median\u00a0=\u00a04.6\u00a0years, range: 0.5\u201316), all patients were alive in complete remission. Five patients suffered from vaginal sequelae with synechiae and\/or stenosis (of whom four had undergone brachytherapy).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Childhood vaginal MGCTs show a highly favorable prognosis with risk\u2010adapted chemotherapy and local treatment of post\u2010chemotherapy residuum (preferably by conservative surgery with partial vaginectomy). Brachytherapy could be an alternative when conservative surgery is not deemed possible or in cases of incomplete resection with residual viable cells.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30697","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T17:33:20Z","timestamp":1696613600000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcome and late effects of patients treated for childhood vaginal malignant germ cell tumors"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0590-5507","authenticated-orcid":false,"given":"Robin","family":"Coppin","sequence":"first","affiliation":[{"name":"Department of Children and Adolescents Oncology Gustave Roussy Paris\u2010Saclay University  Villejuif 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