Immature teratomas: identification of patients at risk for malignant recurrence.
Immature teratomas: identification of patients at risk for malignant recurrence.
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未成熟畸胎瘤：识别有恶性复发风险的患者。
DOI：
10.1093/jnci/81.11.870
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发表时间：
1989
期刊：
影响因子：
--
通讯作者：
Siegel,SE
中科院分区：
文献类型：
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作者：
Malogolowkin,MH;Ortega,JA;Krailo,M;Gonzalez,O;Mahour,GH;Landing,BH;Siegel,SE
我们调查了1941年至1986年在洛杉矶儿童医院诊断和治疗的28例未成熟畸胎瘤患者中未成熟成分在良性畸胎瘤中的意义。分析不同特征，包括年龄、性别、原发肿瘤部位、手术类型（完全切除vs.部分切除或活检）和术前甲胎蛋白（AFP）水平，以评估其与随后局部恶性肿瘤复发风险的相关性。经过6年的中位随访，21例患者存活，无肿瘤复发（72%无事件生存）。1例患者术后死于感染，6例患者在诊断后1年内局部恶性肿瘤复发。在28例患者中，12例在诊断时测量了AFP水平。8例患者的水平正常，没有进一步的证据表明肿瘤复发，4例水平升高，3例肿瘤复发。我们的经验表明，只有在诊断时，AFP水平与这些肿瘤随后的恶性行为相关（P= 0.004）。诊断时未成熟畸胎瘤和AFP水平升高的患者应在初次手术切除后接受辅助化疗[J Natl Cancer Inst 81：870-874，1989]。
We investigated the significance of immature elements in an otherwise benign teratoma in 28 patients with immature teratomas diagnosed and treated at the Childrens Hospital of Los Angeles from 1941 to 1986. Different characteristics, including age, sex, primary tumor site, type of surgery (complete resection vs. partial resection or biopsy), and preoperative levels of alpha-fetoprotein (AFP) were analyzed to evaluate their association with risk of subsequent local malignant recurrence. After a median follow-up of 6 years, 21 patients are alive with no recurrence of the tumor (72% event-free survival). One patient died from infection after surgery and six patients had local malignant tumor recurrence within 1 year from diagnosis. Of the 28 patients, 12 had AFP levels measured at diagnosis. Eight patients had normal levels with no further evidence of tumor recurrence, and four had elevated levels with three tumor recurrences. Our experience demonstrates that only at the time of diagnosis do AFP levels correlate with a subsequent malignant behavior of these tumors (P= .004). Those patients with immature teratomas and elevated AFP levels at diagnosis should receive adjuvant chemotherapy after the initial surgical resection [J Natl Cancer Inst 81:870–874, 1989]