title: Analysis of recurrence risks for sacrococcygeal teratoma in children.
abstract: OBJECTIVE
  The purpose of this study was to investigate effects of risk factors on recurrence of sacrococcygeal teratoma (SCT).
  
  
  METHODS
  A retrospective review was conducted of 107 SCTs treated between January 2003 and December 2012 in our center. Risk factors were identified by univariate and multivariate analysis.
  
  
  RESULTS
  Sixteen children had recurrence of SCT a median interval of 16.25months after primary surgery. 15.6% tumors recurrence were Altman type I, 10.5% type II, 10.0% type III, and 31.3% type IV. The recurrence of mature teratoma was observed in 8 patients, immature in 2, malignant in 5. More than half of the recurrences showed a shift towards histological immaturity or malignancy, compared with the primary tumor pathology. Risk factors for recurrence were spillage of tumor parenchyma during operation (P=0.028), incomplete resection (p=0.000), and primary immature (P=0.029) and malignant histology (P=0.026). Size, Altman classification, and age were not risk factors for recurrence. There was a statistically significant difference in OS between patients who developed relapse (64.8%) and those who did not (95.0%) (P=0.0002).
  
  
  CONCLUSIONS
  Tumor recurrence affected the outcome of children with SCT. Risk factors were tumor spillage, immature and malignant histology, or incomplete resection. Regular follow-up after surgery is mandatory to find tumor relapse earlier and to improve the outcome.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai.
authors.forename: Wei
authors.initials: W
authors.lastname: Yao
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai. Electronic address: likai2727@163.com.
authors.forename: Kai
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai.
authors.forename: Shan
authors.initials: S
authors.lastname: Zheng
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai.
authors.forename: Kuiran
authors.initials: K
authors.lastname: Dong
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai.
authors.forename: Xianmin
authors.initials: X
authors.lastname: Xiao
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000145:classification / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D012445:Sacrococcygeal Region / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D013724:Teratoma / Q000145:classification / Q000473:pathology* / Q000601:surgery
keywords: Recurrence; Risk factors; Sacrococcygeal teratoma