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Fuentes C, Ouldbey Y, Orbach D, Sudour-Bonnange H, Verité C, Rome A, Dumesnil C, Thebaud E, Hameury F, Dijoud F, Chabaud S, Cote MD, Fresneau B, Faure-Conter C. Oncological and endocrinological outcomes for children and adolescents with testicular and ovarian sex cord-stromal tumors. Results of the TGM13 National Registry. Pediatr Blood Cancer 2024; 71:e30864. [PMID: 38259036 DOI: 10.1002/pbc.30864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/23/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024]
Abstract
RATIONALE Sex cord-stromal tumors (SCST) are hormonally active and rare. The aim was to describe their endocrinological presentation and outcomes. METHOD Patients (< 19 years) registered in the TGM13 registry between 2014 and 2021 for SCST were selected. RESULTS Sixty-three ovarian SCST (juvenile granulosa tumor (JGT) n = 34, Sertoli-Leydig cell tumor (SLCT) n = 17, other SCST n = 12) were included. Median age was 13.1 years (0.4-17.4). Germline DICER1 pathogenic variant was present in 9/17 SLCT. Sixty-one were FIGO stage I (IC n = 14). Adjuvant chemotherapy was administered for 15. Seven had recurrence (FIGO IA n = 3, IX n = 2, III n = 2), leading to one death. With a median follow-up of 42 months (2.5-92), the 3-year progression-free survival (PFS) was 89% (95% CI 76%-95%). Median age was 6.4 years (0.1-12.9) among the 15 testicular SCST (Leydig cell tumor n = 6, JGT n = 5, Sertoli cell tumor n = 3, mixed SCST n = 1). Tumor-nodes-metastases (TNM) stage was pSI in 14. Eight underwent a tumorectomy, 7 an orchiectomy. None experienced recurrence. Endocrinological data were reviewed for 41 patients (18 prepubescent). Endocrine symptoms were present at diagnosis in 29/34 females and 2/7 males (gynecomastia). After a median follow-up of 11 months, 15 patients had persistent endocrine abnormalities: gynecomastia/breast growth (2 males, 1 prepubescent female), precocious/advanced puberty (4 prepubescent females), and hirsutism/menstruation disorders/voice hoarseness/hot flashes (8 pubescent females). The mean height at the last follow-up was within normal ranges (+0.3 standard deviation). CONCLUSIONS SCSTs have a favorable prognosis. Tumorectomy appears safe with testicular primary. Endocrinological disorders, common at diagnosis, may persist warranting endocrinological follow-up.
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Affiliation(s)
- Clemence Fuentes
- Department of Pediatric Oncology, Institut d'Hemato-oncologie Pediatrique, Lyon, France
| | - Yaelle Ouldbey
- Statistical Unit, Clinical Research Department, Centre Léon Bérard, Lyon, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer) Institut Curie, PSL University, Paris, France
| | - Helene Sudour-Bonnange
- Anti-Cancer Center Oscar Lambret, Pediatric and Adolescents Oncology Unit, Lille, France
| | - Cecile Verité
- Pediatric Hematology-Oncology Unit, Pellegrin Hospital, CHU Bordeaux, Bordeaux, France
| | - Angelique Rome
- Department of Pediatric Oncology of Timone Children's Hospital, Marseille, France
| | - Cecile Dumesnil
- Department of Pediatric Oncology, University Hospital Center of Rouen, Rouen, France
| | - Estelle Thebaud
- Department of Pediatric Oncology, University Hospital Center of Nantes, Nantes, France
| | - Frederic Hameury
- Department of Pediatric Surgery, Hôpital Femme Mère Enfant, Lyon, France
| | | | - Sylvie Chabaud
- Statistical Unit, Clinical Research Department, Centre Léon Bérard, Lyon, France
| | - M Daval Cote
- Département of Endocrinology and Pediatric Diabetology, Hospices civils de Lyon, Lyon, France
| | - Brice Fresneau
- Gustave Roussy, Université Paris-Saclay, Department of Children and Adolescent Oncology, Paris-Saclay University, Paris-Sud University, CESP, INSERM, Villejuif, France
| | - Cecile Faure-Conter
- Department of Pediatric Oncology, Institut d'Hemato-oncologie Pediatrique, Lyon, France
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