Is intrapelvic tumor height correlated with long-term functional outcomes after surgical treatment of sacrococcygeal teratoma?

Abstract 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 identify predictive factors for these outcomes. Methods: Medical records of all patients who underwent surgery for SCT at the Armand Trousseau Hospital and had a minimum follow-up of 4 years were retrospectively reviewed. Age-appropriate questionnaires were used to evaluate urinary and anorectal functions and QoL. Urodynamic studies and radiological images were also retrospectively reviewed. Results: Twenty-six patients (median age=17 years) were identified. Among them, 12 patients had 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). Anorectal dysfunction (n=12) included chronic constipation (n=11) and/or fecal soiling (n=8). A significant correlation was observed between adverse outcomes and intrapelvic tumor height (ITH) (median was 27 mm and 15 mm with and without functional impairments, respectively; p<0.05). Of 12 questionnaire respondents, two patients experienced uro-anorectal dysfunction and five experienced isolated anorectal dysfunction. Most patients reported having a good QoL, and only one patient reported a severe impact on daily life. Conclusions: Urinary and anorectal dysfunctions are non-negligible long-term outcomes in SCT patients that are significantly related to ITH. Postoperative follow-up enables early detection of bladder and anorectal impairment and treatment with conservative measures that can improve QoL. Level of evidence: III