This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Factors associated with recurrence and metastasis in sacrococcygeal teratoma. BJS 2006; 93: 1543-1548.
Published: 23rd October 2006
Authors: J. P. M. Derikx, A. De Backer, L. van de Schoot, D. C. Aronson, Z. J. de Langen, T. L. van den Hoonaard et al.
Background
Sacrococcygeal teratoma (SCT) is a relatively uncommon tumour, with a high risk of recurrence and metastasis. The factors associated with recurrence and metastatic disease were studied.
Method
A retrospective review was conducted of 173 children with SCT treated between January 1970 and February 2003 at the paediatric surgical centres in the Netherlands. Risk factors were identified by univariate and multivariate analysis.
Results
Eight children died shortly after birth or around the time of operation. Nine children, all over 18 months old, had metastases at presentation. Four teratomas with metastasis showed mature histology of the primary tumour. Nineteen children had recurrence of SCT a median interval of 10 months (range 32 days to 35 months) after primary surgery. Risk factors for recurrence were pathologically confirmed incomplete resection (odds ratio (OR) 6·54 (95 per cent confidence interval (c.i.) 2·11 to 20·31)), immature histology (OR 5·74 (95 per cent c.i. 1·49 to 22·05)) and malignant histology (OR 12·83 (95 per cent c.i. 3·27 to 50·43)). Size, Altman classification, age and decade of diagnosis were not risk factors for recurrence. One‐third of the recurrences showed a shift towards histological immaturity or malignancy, compared with the primary tumour. Seven patients died after recurrence, five with malignant disease.
Conclusion
This national study showed that SCT recurred in 11 per cent of the children within 3 years of operation. Risk factors were immature and malignant histology, or incomplete resection. Mature teratoma has the biological capability to become malignant. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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