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Intracranial germ cell tumors: a multi-institutional experience from three tertiary care centers in India

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An Erratum to this article was published on 22 August 2016

Abstract

Objective

Central nervous system germ cell tumors (CNS GCTs) are relatively rare neoplasms. Incidence of CNS GCTs in Western literature is low (0.3–0.6 %) as compared to East Asia (3–4 %). No large study is available on CNS GCTs from India.

Methods

Intracranial GCT cases were retrieved from databases of three tertiary care institutes in India; clinicopathological data was reviewed.

Results

Ninety-five intracranial GCT cases were identified, accounting for 0.43 % of CNS tumors. Median age was 12 years (range, birth to 48 years); male preponderance was noted (66 %). Most patients (86.3 %) were aged <18 years. Pineal location was most common (45 %) and was associated with male gender and age >14 years. Germinoma was the commonest histopathological type (63.2 %), followed by teratoma (20 %). Suprasellar location was associated with germinoma histology. Follow-up was available for 71 patients (median, 15 months). Of these, 48 received adjuvant chemotherapy and/or radiotherapy. At the last follow-up, 44 patients showed no evidence of disease. Age >10 years, male gender, pineal location, and germinoma histology were associated with favorable outcome.

Conclusion

This is the first multicentric study from India establishing that incidence of CNS GCT in India is similar to that in the West and differs from that in East Asian countries. However, similar to both, germinoma is the commonest histological type, and pineal location is most frequent. Studies on molecular alterations based on ethnicity and geographical location are necessary to provide clarity on differences in incidence. Attention needs to be focused on decreasing treatment heterogeneity and minimizing treatment-related morbidity and mortality, improving the cure rate of these highly treatable tumors.

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Authors and Affiliations

  1. Department of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India

    Aanchal Kakkar, Vaishali Suri, Mehar C. Sharma & Chitra Sarkar

  2. Department Radiation Oncology, All India Institute of Medical Sciences, New Delhi, 110029, India

    Ahitgani Biswas, Supriya Mallick & Pramod K. Julka

  3. Neuro Oncology Group, Tata Memorial Hospital, Mumbai, 400012, India

    Nikhil Kalyani, Girish Chinnaswamy, Brijesh Arora, Epari Sridhar & Rakesh Jalali

  4. Department of Pathology, IPGMER, Kolkata, 700020, India

    Uttara Chatterjee

  5. Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, 110029, India

    Nishant Goyal & Bhawani S Sharma

  6. Department of Neurosurgery, Park Clinic, Kolkata, India

    Sandip Chatterjee

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  1. Aanchal Kakkar
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Correspondence to Chitra Sarkar.

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The authors report no conflict of interest concerning the findings specified in this paper.

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Rakesh Jalali and Chitra Sarkar have contributed equally to this manuscript and are co-corresponding authors.

An erratum to this article is available at http://dx.doi.org/10.1007/s00381-016-3222-z.

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Kakkar, A., Biswas, A., Kalyani, N. et al. Intracranial germ cell tumors: a multi-institutional experience from three tertiary care centers in India. Childs Nerv Syst 32, 2173–2180 (2016). https://doi.org/10.1007/s00381-016-3167-2

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