Analysis of recurrence risks for sacrococcygeal teratoma in children

Background/Purpose: The purpose of this study was to investigate effects of risk factors on recurrence of sacrococcygeal teratoma (SCT). Methods: A retrospective review was conducted of 107 SCTs treated between January 2003 and December 2012 in our center. Risk factors were identified by univariate and multivariate analysis. Results: Sixteen children had recurrence of SCT a median interval of 16.25 months after primary surgery. 15.6% tumors recurrence were Altman type I, 10.5% type II, 10.0% type III, and 31.3% type IV. The recurrence of mature teratoma was observed in 8 patients, immature in 2, malignant in 5. More than half of the recurrences showed a shift towards histological immaturity or malignancy, compared with the primary tumor pathology. Risk factors for recurrence were spillage of tumor parenchyma during operation (P = 0.028), incomplete resection (p = 0.000), and primary immature (P = 0.029) and malignant histology (P = 0.026). Size, Altman classification, and age were not risk factors for recurrence. There was a statistically significant difference in OS between patients who developed relapse (64.8%) and those who did not (95.0%) (P = 0.0002). Conclusions: Tumor recurrence affected the outcome of children with SCT. Risk factors were tumor spillage, immature and malignant histology, or incomplete resection. Regular follow-up after surgery is mandatory to find tumor relapse earlier and to improve the outcome. (C) 2014 Elsevier Inc. All rights reserved.