Results:
We enrolled 26 patients with SYST (median age 1.7 years; range, 2 months to 5 years). Patients with predominance of female had elevated AFP at diagnosis (median 50,480 ng/ml, range 1,200-80,300,000). Twelve patients were stage Ⅳ. Neoadjuvant chemotherapy was administered to 20 cases. Six patients underwent resection as initial therapy. Resected tumor size at upfront resection was measured < 4.0cm × 3.0cm. No patient died of disease at last follow-up. Relapse occurred in 12 patients. Patients with specimen exhibiting no malignant component after chemotherapy didn’t experience recurrence. Frequencies of recurrence were once in 5 patients, 3 in 2 patients, 2 in 3 patients, 4 in 1 patient and 6 in 1 patient, respectively. All relapsed patients still achieved partial remission (PR) or complete remission (CR) after salvage therapy. The cohort reached a 5-year RFS of 55.2% (median follow-up 59.5 months; range, 16-155). Univariate analysis identified sex as a significant prognostic factor of RFS (P = 0.02). In multivariate Cox regression, no variables had statistically significance. Patients with > 2 factors (boy, initial tumor size > 4cm×3cm, AFP > 60,000 ng/ml and poor pathological response) had poor RFS.