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

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.

Immature Sacrococcygeal Teratoma: A Case Report and Extensive Review of the Literature

“…Although the risk of recurrence is the main follow-up parameter, long-term functional sequelae (constipation, soiling, urinary incontinence, vicious appearance of the scar, and quality of life) represent particularly important criteria [74]. Long-term monitoring of SCT after surgical treatment is important due to the increased rate (of approximately 20%) of urological (urinary incontinence) and intestinal (constipation ± faecal soiling) sequelae [75]. As a result, counseling the family in the surgical management of these cases is decisive for a favorable prognosis.…”

Diagnosis and management of a sacrococcygeal teratoma at a tertiary hospital in northern Tanzania: A case report

“…Complete surgical resection provides a cure for benign sacrococcygeal teratoma [ 12 ]. Malignant sacrococcygeal teratomas with negative margins after resection (stage 1) warrants observation after resection.…”

“…Platinum-based chemotherapeutic regimens such as CISplatin are recommended. After completion of treatment, patients should be followed up for up to five years to assess for recurrence [ [12] , [13] , [14] ].…”