Intrapelvic Tumor Height as a Promising Novel Prognostic Indicator for Long-Term Functional Outcomes in...

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).

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.

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.

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.