Management strategy and outcomes of sacrococcygeal teratoma - an Egyptian multicenter experience.
Ahmed Elgendy, Amr Abdelhamid AbouZeid, Mohamed El-Debeiky, Mahmoud Mostafa, Mohammed Hamada Takrouney, Mohamed Abouheba, Ahmed Khairi, Sameh Shehata, Sherif M Shehata
Author Information
Ahmed Elgendy: Surgical Oncology Unit, Department of Surgery, Faculty of Medicine, Tanta University, Tanta, 31515, Egypt. ahmed.elgendy@med.tanta.edu.eg. ORCID
Amr Abdelhamid AbouZeid: Pediatric Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Mohamed El-Debeiky: Pediatric Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Mahmoud Mostafa: Pediatric Surgery Unit, Department of Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt.
Mohammed Hamada Takrouney: Pediatric Surgery Unit, Department of Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt.
Mohamed Abouheba: Pediatric Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Ahmed Khairi: Pediatric Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Sameh Shehata: Pediatric Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Sherif M Shehata: Pediatric Surgery Unit, Department of Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.
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.
