{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T17:40:24Z","timestamp":1787247624100,"version":"build-2736575974"},"reference-count":38,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T00:00:00Z","timestamp":1699920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the National Natural Science Foundation of China","award":["82070126"],"award-info":[{"award-number":["82070126"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objective: The aim was to describe the clinical features of extracranial germ cell tumors (GCTs) in pediatrics and study the clinical risk factors related to survival for malignant germ cell tumors (MGCTs) in order to optimize therapeutic options. Methods: The clinical data of children with extracranial GCTs in three children\u2019s medical centers in Shanghai were retrospectively analyzed. Results: In total, 1007 cases of extracranial GCTs diagnosed between 2010 and 2019 were included in this study, including teratomas (TERs) 706 (70.11%) and MGCTs 301 (29.89%). There were twice as many TER cases as MGCT cases. Approximately 50% of children with GCTs were &lt;3 years old (43.39% for TERs, 67.13% for MGCTs). GCTs in children of different ages show differences in tumor anatomical locations and pathological subtypes. The 5-year event-free survival (EFS) and overall survival (OS) of all patients with MGCTs were 82.33% (95% CI, 77.32%, 86.62%) and 94.13% (95% CI, 90.02%, 96.69%), respectively. The multivariate Cox regression analysis identified a primary site in the mediastinum and alpha fetoprotein (AFP) levels \u226510,000 ng\/mL as independent adverse prognostic factors (p &lt; 0.0.0001, \u03c72 = 23.6638, p = 0.0225, \u03c72 = 5.2072.). There were no significant differences in OS among children receiving various chemotherapy regimens, such as the BEP, PEB, JEB and other regimens (VBP\/VIP and AVCP\/IEV) (p &lt; 0.05). Conclusions: The clinical features of GCTs in Chinese pediatrics are similar to those reported in children in Europe and America. The age distribution of pathological types and primary sites in GCTs reflect the developmental origin of type I and type II GCTs transformed from mismigration primordial germ cells (PGCs). Optimizing the current platinum-based chemotherapy regimens and exploring the treatment strategies for MGCTs of the mediastinum are future research directions.<\/jats:p>","DOI":"10.3390\/cancers15225412","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T11:04:32Z","timestamp":1699959872000},"page":"5412","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Extracranial Germ Cell Tumors in Children: Ten Years of Experience in Three Children\u2019s Medical Centers in Shanghai"],"prefix":"10.3390","volume":"15","author":[{"given":"Shayi","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuiran","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Children\u2019s Hospital of Fudan University, Shanghai 201102, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Children\u2019s Hospital of Fudan University, Shanghai 201102, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangbin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyang","family":"Jiao","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yali","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, No. 1678 Dongfang Road, Shanghai 200127, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuelian","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhibao","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Shanghai Children\u2019s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Shanghai 200061, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7592-4115","authenticated-orcid":false,"given":"Yijin","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, No. 1678 Dongfang Road, Shanghai 200127, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1200\/JOP.19.00190","article-title":"Germ Cell Tumors in Adolescents and Young Adults","volume":"15","author":"Fonseca","year":"2019","journal-title":"J. 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Surg."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/22\/5412\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:22:56Z","timestamp":1760131376000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/22\/5412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,14]]},"references-count":38,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["cancers15225412"],"URL":"https:\/\/doi.org\/10.3390\/cancers15225412","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,14]]}}}