骶尾部畸胎瘤的恶性转化和肿瘤复发:一项全球性回顾性队列研究。

IF 12.5 2区 医学 Q1 SURGERY International journal of surgery Pub Date : 2024-09-06 DOI:10.1097/JS9.0000000000002045
L J van Heurn, Jpm Derikx, N Hall, J H Aldrink, M M Bailez, L B Chirdan, S Fumino, A Hesse, T Soyer, S StPeter, J Twisk, T Yang, Lwe van Heurn
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引用次数: 0

摘要

简介:骶尾部畸胎瘤(SCT)是一种罕见的先天性肿瘤:骶尾部畸胎瘤(SCT)是一种罕见的先天性肿瘤。恶性肿瘤和复发的风险尚不明确。以往的研究规模较小,对手术时机和随访时间的结论也不尽相同。为了弥补这些不足,我们研究了手术后恶性转化和SCT复发的风险:这是一项全球性的回顾性队列研究。我们从 62 个国家的 145 家机构获得了连续 SCT 患者的数据。研究分析了恶性转化(定义为初次切除时的恶性肿瘤、恶性肿瘤复发或因恶性肿瘤死亡)及其风险因素:结果:在纳入的 3612 例患者中,有 3407 例进入分析。3个月、6个月、1年和2岁时,初始肿瘤恶性转化的风险分别为3.3%、5.1%、10.1%和32.9%。六年后,恶性肿瘤的删减风险(64%)没有进一步增加。349例(10-2%)患儿被诊断为复发性SCT,其中126例(36-1%)为恶性复发。复发的风险因素为Altman II型(几率比(OR):1-6,95%置信区间(CI):1-2-2-3)、Altman III型(OR:1-6,95% CI:1-2-2-3)、初始不成熟组织学(OR:1-9,95% CI:1-4-2-6)和初始恶性组织学(OR:4-0,95% CI:2-9-5-4):结论:SCT最初切除时发生恶性肿瘤的风险随着年龄的增长而增加,到6岁时达到高峰。10%的患者在切除术后复发,其中36%当时为恶性。阿尔特曼II型或III型、组织学不成熟或恶性与复发有关。
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Malignant transformation and tumour recurrence in sacrococcygeal teratoma: a global, retrospective cohort study.

Introduction: Sacrococcygeal teratoma (SCT) is a rare congenital tumour. The risk of malignancy and recurrence are not well defined. Previous studies are small and report differing conclusions about the timing of surgery and the duration of follow-up. We studied the risk of malignant transformation and SCT recurrence after surgery to address these gaps.

Methods: This was a global retrospective cohort study. Data of consecutive SCT patients was obtained from 145 institutes in 62 countries. Malignant transformation, defined as malignancy at initial resection, malignant recurrence or death due to malignancy, and its risk factors were analysed.

Results: Of the 3612 included patients, 3407 entered analysis. Risk of malignant transformation of the initial tumour, was 3.3%, 5.1%, 10.1%, and 32.9% at age three months, six months, one year, and two years, respectively. After six years, the censored risk of malignancy (64%) did not further increase. Recurrent SCT was diagnosed in 349 (10·2%) children with 126 (36·1%) malignant recurrences. Risk factors for recurrence were Altman type II (odds ratio (OR): 1·6, 95% confidence interval (CI): 1·2-2·3), Altman type III (OR: 1·6, 95% CI: 1·2-2·3), initial immature histology (OR: 1·9, 95% CI: 1·4-2·6), and initial malignant histology (OR: 4·0, 95% CI: 2·9-5·4).

Conclusion: The risk of malignancy at initial resection in SCT increases with age reaching a plateau at six years of age. Recurrence after resection occurred in 10% of patients and 36% of these were malignant at that time. Altman type II or type III, and immature or malignant histology were associated with recurrence.

Level of evidence: level III.

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来源期刊
CiteScore
17.70
自引率
3.30%
发文量
0
审稿时长
6-12 weeks
期刊介绍: The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.
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