Abstract：
OBJECTIVE: To evaluate the association between serum alpha-fetoprotein (AFP) half-life (HL) and prognosis in prepubertal children with elevated AFP values 3 to 4 weeks after surgery for testicular yolk sac tumors (YST).
METHODS: Prepubertal patients with testicular YST treated with radical orchiectomy between January 2016 and December 2022 were retrospectively reviewed. Negative outcomes were defined as relapse, metastasis or death. Univariate and multivariate logistic regression analyses were conducted to select risk factors for negative outcomes.
RESULTS: A total of 42 patients were eventually enrolled into the study. Patients were divided into non-negative and negative outcomes groups, consisting of 35 and 7 patients, respectively. Thirty-five patients were stage I, two cases were stage II, and five cases were stage IV, according to the Children\'s Oncology Group staging system. The overall survival (OS) rate was 100%. Average AFP values significantly decreased after resection (P < 0.001). A significant positive correlation was shown between pre- and postoperative AFP values (r = 0.60, P < 0.001). Long AFP HL was considered as an independent risk factor for negative outcomes in YST patients underwent radical orchiectomy (P = 0.04). The cut-off value for AFP HL was 5.78 days, regardless of age division.
CONCLUSIONS: Testicular YST is a relatively rare disease in children with an OS of 100%, and salvage chemotherapy is effective even in grade IV patients. The postoperative AFP HL was significantly associated with prognosis in prepubertal patients with testicular YST. The cut-off value for AFP HL is 5.78 days regardless of the effect of physiological AFP elevation.
METHODS: Prepubertal patients with testicular YST treated with radical orchiectomy between January 2016 and December 2022 were retrospectively reviewed. Negative outcomes were defined as relapse, metastasis or death. Univariate and multivariate logistic regression analyses were conducted to select risk factors for negative outcomes.
RESULTS: A total of 42 patients were eventually enrolled into the study. Patients were divided into non-negative and negative outcomes groups, consisting of 35 and 7 patients, respectively. Thirty-five patients were stage I, two cases were stage II, and five cases were stage IV, according to the Children\'s Oncology Group staging system. The overall survival (OS) rate was 100%. Average AFP values significantly decreased after resection (P < 0.001). A significant positive correlation was shown between pre- and postoperative AFP values (r = 0.60, P < 0.001). Long AFP HL was considered as an independent risk factor for negative outcomes in YST patients underwent radical orchiectomy (P = 0.04). The cut-off value for AFP HL was 5.78 days, regardless of age division.
CONCLUSIONS: Testicular YST is a relatively rare disease in children with an OS of 100%, and salvage chemotherapy is effective even in grade IV patients. The postoperative AFP HL was significantly associated with prognosis in prepubertal patients with testicular YST. The cut-off value for AFP HL is 5.78 days regardless of the effect of physiological AFP elevation.
摘要：
目的：评价睾丸卵黄囊瘤(YST)术后3~4周AFP值升高的青春期前儿童血清甲胎蛋白(AFP)半衰期(HL)与预后的关系。
方法：对2016年1月至2022年12月接受根治性睾丸切除术的青春期前睾丸YST患者进行回顾性分析。阴性结果定义为复发，转移或死亡。进行单变量和多变量逻辑回归分析以选择阴性结果的危险因素。
结果：共有42名患者最终被纳入研究。患者分为非阴性和阴性结果组，由35和7名患者组成，分别。35名患者是I期,两例为II期,五例为IV期,根据儿童肿瘤学组分期系统。总生存率(OS)为100%。切除后平均AFP值显着降低（P<0.001）。术前、术后AFP值呈显著正相关(r=0.60,P<0.001)。长AFPHL被认为是YST患者行根治性睾丸切除术阴性结局的独立危险因素(P=0.04)。AFPHL的截止值为5.78天，不分年龄。
结论：睾丸YST在OS为100%的儿童中是一种相对罕见的疾病，即使在IV级患者中，挽救性化疗也是有效的。青春期前睾丸YST患者术后AFPHL与预后显著相关。AFPHL的截断值为5.78天，与生理AFP升高的影响无关。
方法：对2016年1月至2022年12月接受根治性睾丸切除术的青春期前睾丸YST患者进行回顾性分析。阴性结果定义为复发，转移或死亡。进行单变量和多变量逻辑回归分析以选择阴性结果的危险因素。
结果：共有42名患者最终被纳入研究。患者分为非阴性和阴性结果组，由35和7名患者组成，分别。35名患者是I期,两例为II期,五例为IV期,根据儿童肿瘤学组分期系统。总生存率(OS)为100%。切除后平均AFP值显着降低（P<0.001）。术前、术后AFP值呈显著正相关(r=0.60,P<0.001)。长AFPHL被认为是YST患者行根治性睾丸切除术阴性结局的独立危险因素(P=0.04)。AFPHL的截止值为5.78天，不分年龄。
结论：睾丸YST在OS为100%的儿童中是一种相对罕见的疾病，即使在IV级患者中，挽救性化疗也是有效的。青春期前睾丸YST患者术后AFPHL与预后显著相关。AFPHL的截断值为5.78天，与生理AFP升高的影响无关。
