GERM-08. EARLIER RECOGNITION OF SYMPTOMS AND DIAGNOSIS MAY REDUCE TREATMENT AND LATE EFFECT BURDEN IN CHILDREN, TEENAGERS AND YOUNG ADULTS WITH INTRACRANIAL GERM CELL TUMOURS
Bibliographic record
Abstract
Prolonged symptom intervals (SI) are frequently seen in malignant intracranial germ cell tumours (iGCTs) and have been associated with inferior outcomes in other brain tumours. This study reviewed the clinical presentation of iGCTs and examined the effect of prolonged SI on this group. Clinical data were retrospectively reviewed for patients (diagnosed with an iGCT (January 2002-December 2011) from 6 centres [4 UK (n=45), 1 German (n=11) and 1 Canadian (n=31)]. Fisher’s exact test used for comparisons (p<0.05 significant). Study cohort included 87 (58M:29F) patients [59 germinoma, and 28 non-germinoma] with tumours located in pineal (34), suprasellar (25), bifocal (24) and other area (4), of which 16 were metastatic. Median age at diagnosis was 11.5 years (0.6-22.6y). The time to diagnosis from first symptom (SI) ranged from 0-69 months (median 3m, mean 8.5m). A prolonged SI (> 6months) was observed in one third of patients (n=28) and significantly associated with metastatic disease (11/28 vs. 5/59, p=0.002) at diagnosis. In patients with a prolonged SI, endocrine symptoms, particularly diabetes insipidus (DI), were common (75%) but raised intracranial pressure (RICP) was infrequent (14%). In contrast, those with a SI <6 months frequently presented with RICP (84%, p<0.0001). One third of patients with an iGCT have symptoms >6 months prior to diagnosis. Delayed diagnosis is associated with metastatic disease. Early symptom recognition, particularly related to hormonal disturbances without RICP, may improve timely diagnosis, reduce frequency of metastatic disease and thus reduce the burden of treatment and late-effects.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".