title: Long-term outcomes of surgery for malignant sacrococcygeal teratoma: 20-year experience of a regional UK centre.
abstract: BACKGROUND
  The timing of surgery for malignant sacrococcygeal teratoma is controversial. The long-term outcomes and complications of surgery for this rare tumour are presented.
  
  
  METHODS
  All cases of malignant sacrococcygeal teratoma in the 20-year period 1987-2006 were identified and the case notes retrieved. The age at diagnosis, investigations, presentation, type of surgery, early complications, recurrence rates, long-term complications and outcomes were recorded.
  
  
  RESULTS
  Twelve patients (three males, nine females) were identified. Mean age at presentation was 20.8 months (range: 12-39 months). All had the Carboplatin-Etoposide-Bleomycin chemotherapeutic protocol. The average time of follow-up was 10.6 years (range: 1-17 years). Ten patients had excision of their tumours following chemotherapy, whilst two patients had excision prior to chemotherapy. Two patients had recurrence of their tumours. There was one death (8%), which was due to disseminated metastasis. The other 11 children were all well at the last follow-up.
  
  
  CONCLUSIONS
  Surgery for malignant sacrococcygeal teratoma is safe and has a low complication rate. The long-term outcomes are favourable with minimal side effects.
authors.affiliation: Department of Paediatric Surgery, Royal Manchester Children's Hospital, Pendlebury, Manchester, UK. Kba_bas@hotmail.co.uk
authors.forename: Basem A
authors.initials: BA
authors.lastname: Khalil
authors.forename: Asher
authors.initials: A
authors.lastname: Aziz
authors.forename: Pierina
authors.initials: P
authors.lastname: Kapur
authors.forename: Gill
authors.initials: G
authors.lastname: Humphrey
authors.forename: Antonino
authors.initials: A
authors.lastname: Morabito
authors.forename: James
authors.initials: J
authors.lastname: Bruce
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001761:Bleomycin / Q000008:administration & dosage; D016190:Carboplatin / Q000008:administration & dosage; D002675:Child, Preschool; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D020360:Neoadjuvant Therapy; D012445:Sacrococcygeal Region; D013125:Spinal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D013724:Teratoma / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D001761:Bleomycin; D005047:Etoposide; D016190:Carboplatin