Long-term functional sequelae of sacrococcygeal teratoma: a national study in The Netherlands |
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Authors: | Derikx Joep P M De Backer Antoine van de Schoot Léon Aronson Daniel C de Langen Zacharias J van den Hoonaard Thelma L Bax Nicolaas M A van der Staak Frans van Heurn L W Ernest |
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Institution: | a Department of Surgery, University Hospital, PO Box 5800, Maastricht 6200 AZ, The Netherlands b Department of Pediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands c Pediatric Surgical Centre of Amsterdam (Emma Children's Hospital AMC/Vrije University Medical Centre), The Netherlands d Department of Surgery, University Medical Centre Groningen, The Netherlands e Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, The Netherlands f Department of Pediatric Surgery, Radboud University Nijmegen Medical Centre, The Netherlands |
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Abstract: | BackgroundLong-term functional sequelae after resection of sacrococcygeal teratoma (SCT) are relatively common. This study determines the incidence of these sequelae associated clinical variables and its impact on quality of life (QoL).Patients and methodsPatients with SCT treated from 1980 to 2003 at the pediatric surgical centers in the Netherlands aged more than 3 years received age-specific questionnaires, which assessed parameters reflecting bowel function (involuntary bowel movements, soiling, constipation), urinary incontinence, subjective aspect of the scar, and QoL. These parameters were correlated with clinical variables, which were extracted from the medical records. Risk factors were identified using univariate analysis.ResultsOf the 99 posted questionnaires, 79 (80%) were completed. The median age of the patients was 9.7 years (range, 3.2-22.6 years). There were 46% who reported impaired bowel function and/or urinary incontinence (9% involuntary bowel movements, 13% soiling, 17% constipation), and 31% urinary incontinence. In 40%, the scar was cosmetically unacceptable. Age at completion of the questionnaire, Altman classification, sex, and histopathology were not risk factors for any long-term sequelae. Size of the tumor (>500 cm3) was a significant risk factor for cosmetically unacceptable scar (odds ration OR], 4.73; confidence limit CL], 1.21-18.47; P = .026). Long-term sequelae were correlated with diminished QoL.ConclusionA large proportion of the patients with SCT have problems with defecation, urinary incontinence, or a cosmetically unacceptable scar that affects QoL. Patients who are at higher risk for the development of long-term sequelae cannot be clearly assessed using clinical variables. |
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Keywords: | Sacrococcygeal teratoma Bowel function Urinary incontinence Long-term Sequelae |
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