LINC-22. Primary central nervous system (CNS) germ cell tumors (GCT) in Central America and the Caribbean region: an AHOPCA 20-year experience
Bibliographic record
Abstract
Abstract BACKGROUND: Primary CNS GCT are rare neoplasms in pediatrics. Treatment depends on histological subtype and extent of disease. Overall survival (OS) is above 85% in high-income countries (HIC). OBJECTIVE: To describe the experience in treating CNS GCT in 4 of 8 countries, members of AHOPCA (Asociación de Hemato-Oncología Pediátrica de Centro América) and 5-year OS. DESIGN/METHODS: We conducted a retrospective chart review of patients treated for CNS GCT. Epidemiological, clinical characteristics, histology, treatment modalities and outcome were analyzed. RESULTS: From 2001 to 2021, 45 patients were included. Guatemala: 22, Nicaragua: 15, Dominican Republic: 3 and El Salvador: 5. Thirty (66.6%) were male, mean age at diagnosis was 8.6 years (range 12 months to 17 years). Presenting symptoms were headaches/vomiting (n=26, 57.7 %), visual disturbances (n=15, 33.3%), diabetes insipidus (n=7, 15.5%). Two patients (NGGCT) presented with precocious puberty. Upfront surgery was done in 33 cases (73.33%); 21 (63.6%) germinomas, 9 (27.2%) NGGCT and 3 (9%) CNS GCT. Eight patients were diagnosed and treated based on CSF tumor marker elevation; four germinomas (BHCG 11.32-29.41mUI/mL) and four NGGCT (BHCG 84.43-201.97mUI/mL or positive AFP>10 ng/mL). Tumor locations included suprasellar (n=15, 33.3%), pineal (n=14, 31.1%), thalamus/basal ganglia (n=5, 11%), other (n=6, 13.3%); and one bifocal. Four (8.8%) had metastatic disease, 6 with positive CSF, staging data was incomplete in 25 patients (55.5%). Patients were treated with varied chemotherapy and radiotherapy modalities. Nine patients had incomplete data regarding treatment. Five-year OS was 65% (61.5% for germinoma and 56% for NGGCT). Two patients with histologically confirmed germinoma relapsed. CONCLUSIONS: Germinoma was the most common histology and there was a male predominance. More than half patients had incomplete staging data and treatment was variable. OS is lower compared to HIC. Standardized treatment protocols will aid in adequate staging, treatment planning, prevent complications and improve survival.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".