Retrospective Analysis Of Clinical Characteristics And Prognosis Of Intracranial Germ Cell Tumor

Objective: Intracranial germ cell tumors(ICGCTs)are rare in central nervous system.Recently,with the development of diagnosis and treatment,ICGCTs still lack specific diagnostic method.Through retrospective analysis of the clinical data of ICGCTs in Neurotumor Surgery Department of our hospital,this study aimed to further improve the understanding of the clinical manifestations,imaging characteristics,diagnosis and treatment of ICGCTs.Methods: From December 2009 to December 2019,52 patients hospitalized in the Neurotumor Surgery Department of the First Bethune Hospital of Jilin University were retrospectively analyzed,who were pathologically diagnosed as ICGCTs by craniotomy or histological examination.All the patients' relevant information was collected,including their age,gender,clinical manifestations,auxiliary examination,treatment data,pathological data,postoperative complications and prognosis.All the above information was analyzed and summarized.Statistical methods: Quantitative data were described as mean ± standard deviation or median(range of value).The rank sum test was performed to evaluate the R × C table.Kaplan-Meier method and proportional hazard regression model were used to perform survival analysis,and log-rank method and Breslow method were performed to determine whether the difference was statistically significant.SPSS23 software was used to perform statistical analysis.Results: 52 patients were included in this study.The peak age of onset was 16~20,and the overall median age of onset was 20.5(16~43).Among all the patients,27 were male,and 25 were female,with the ratio of 1.08:1.The median age of onset was 20(17~27)for males and 31(14~53.5)for females.Patients were different in clinical manifestations,in which headache,loss of vision,headache accompanied by nausea and vomiting were more common,followed by polydipsia,polyuria,dyskinesia,etc.,and even epilepsy,fever,loss of appetite and other symptoms might also appear.47 cases showed single tumor,and 5 showed multiple tumors.Among cases with single tumor,sellar region was the most common pathogenic site(17 cases),followed by cerebellum(9 cases),frontal lobe(9 cases),ventricular system(6 cases),pineal region(5 cases),and temporal lobe(1 case).Among the 5 cases with multiple tumors,4 cases had double lesions,and 1 case had 3 lesions.Patients with different gender had no statistical difference in the location of tumors(P=0.06).Among the different pathological subtypes,21 cases were germinomas,20 were mature cystic teratoma,1 was immature teratoma,7 were mixed germ cell tumor and 3 were unclassified teratoma.The 52 patients all underwent craniotomy,of which 39 received total resection and 13 received subtotal resection.A total of 32 patents underwent surgery alone,of which 11 cases received surgery + radiotherapy,8 cases received surgery + radiotherapy + chemotherapy,and 1 case received surgery + chemotherapy.The most common postoperative complication was infection(n=20),followed by no complications(n=18),hydrocephalus(n=7),diabetes insipidus(n=6),hypopituitarism(n=4),loss of vision(n=2),etc.Conclusions: 1.Among the 52 patients in this study,their peak age of onset is 16~20 years old.The clinical manifestations of patients with ICGCTs are atypical and diverse,among which the symptoms of increased intracranial pressure are the main clinical manifestations.2.The prognosis of ICGCTs is related to gender,location of tumor,multiple tumors and treatment method.3.The independent influencing factors of ICGCTs include gender,multiple tumors and treatment method,in which gender and treatment method are protective factors,and multiple tumors are risk factors.