Intrapelvic Tumor Height as a Promising Novel Prognostic Indicator for Long-Term Functional Outcomes in Sacrococcygeal Teratomas.
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BACKGROUND: Sacrococcygeal teratoma (SCT) is considered the most common congenital neoplasm in neonates. This study aimed to assess long-term impacts on urinary and anorectal functions and quality of life (QoL) in patients who underwent surgery for SCT and to identify predictive factors for these outcomes, with a focus on the intrapelvic tumor height (ITH). METHODS: This retrospective study included patients treated surgically for SCT, between 1984 and 2017 at our hospital. Urologic and anorectal functions were evaluated through clinical assessments and patient-reported outcomes through questionnaires. Statistical analysis was performed to explore correlations between these factors and long-term functional outcomes. RESULTS: Twenty-six patients (median age = 17 years) were identified. With a median follow-up of 180 months (96-444 months), 12 patients (46%) presented functional impairments: seven had isolated anorectal dysfunction, and five had both urinary and anorectal dysfunctions, including neurogenic bladder (n = 2) and/or detrusor-sphincter dyssynergia (n = 3). A significant correlation was observed between adverse outcomes and ITH (median ITH was 27 mm in patients with impairments versus 15 mm in those without, p < 0.05). Of the 12 questionnaire respondents, two patients experienced urinary and anorectal dysfunctions, and five experienced isolated anorectal dysfunction. Most patients reported a good QoL, with only one patient reporting a severe impact on daily life. CONCLUSIONS: Long-term urologic and anorectal dysfunctions are prevalent in patients treated for SCT, although the overall impact on QoL remains moderate. Importantly, ITH emerged as a more objective and accurate predictor of functional outcomes than tumor size or Altman classification.