Treatment evaluation of sacrococcygeal endodermal sinus tumor in children

Objective To evaluate the treatment of children with sacrococcygeal endodermal sinus tumor.Methods Clinical data of 14 cases of sacrococcygeal endoderrmal sinus tumor treated from January 2000 to January 2011 in this institute were reviewed retrospectively.There were four male and ten female cases,patients'age ranged from ten months to ten years and seven months.Results In all cases,ten patients who had been treated with preoperative chemotherapy received the resection of tumor and coccyx after completion of two to four cycles PEB /HD-PEB chemotherapy.The postoperative pathology confirmed the diagnosis of chemotherapy improved endodermal sinus tumor or malignant teratoma,accompanied by necrosis or degeneration of deformation of cells.Then the patients continued to PEB/HD-PEB chemotherapy regimen for 2-4 courses.One patient of stage Ⅰ was only underwent complete resection of the tumor and the coccyx.Operation resection rate was 100％,and no rupture of rectum occurred during the surgery Postoperative incision infection occurred in four cases.One patient was lost to follow-up,one patient died of chemotherapy resistance,the other twelve patients were still survived.Conclusions Patients with endodermal sinus tumor of the sacrococcygeal has a good prognosis.Operation with platinum-based chemotherapy is the main treatment.Complete resection of the coccyx is the key to avoid relapse.Neoadjuvant chemotherapy could improve the resection rate of operation.Even negative pathologically detection of malignant tumor cells,postoperative chemotherapy should continue and complete according to pathological diagnosis and staging of tumor before chemotherapy. Key words: Endodermal sinus tumor;  Sacrococcygeal region;  Drug therapy,combination