Management strategy and outcomes of sacrococcygeal teratoma - an Egyptian multicenter experience

World J Surg Oncol. 2023 Sep 18;21(1):294. doi: 10.1186/s12957-023-03180-w.

Abstract

Objectives: Nationwide criteria regarding patients with sacrococcygeal teratoma (SCT) are still lacking in Egypt. We aimed to present a multicenter study regarding the management and outcomes of this tumor to evaluate our national treatment strategy.

Methods: A retrospective analysis including all patients with SCT who were managed at four major Egyptian centers between 2013 and 2023. Clinical data, surgical approaches, and short- and long-term outcomes were discussed.

Results: The study included 95 patients (74 were females). Antenatal diagnosis was reported in 25% of patients. Seventy-one patients (74.7%) were classified as Altman type I/II. Surgery was performed via a perineal approach in 75 patients, whereas the remaining 20 underwent a combined abdominoperineal approach. Vertical elliptical incision with midline closure was conducted in 51.5% of patients, followed by classic or modified chevron incisions. Benign mature teratoma was detected in 82% of patients. At a median follow-up of 57 months, eight patients (8.5%) had relapsed. The 5-year overall survival (OS) and event-free survival (EFS) of all patients were 94% and 91%, respectively. In the after-care monitoring, 19 patients (20%) had urinary or bowel dysfunctions. Nine of them were managed using medications. Clean intermittent catheterization was practiced in another five patients. The remaining five underwent further surgical interventions.

Conclusion: Favorable outcomes were achieved in our country during the last decade. Diverse perineal incisions were performed for resection, and vertical elliptical with midline closure was the commonest. During follow-up, 20% of patients developed urological or bowel dysfunctions that required medical and surgical treatment modalities to improve their quality of life.

Keywords: Outcomes; Relapse; Sacrococcygeal teratoma; Surgery.

Publication types

  • Multicenter Study

MeSH terms

  • Egypt / epidemiology
  • Female
  • Humans
  • Male
  • Pregnancy
  • Quality of Life
  • Retrospective Studies
  • Spinal Neoplasms*
  • Surgical Wound*
  • Teratoma* / surgery