Sacrococcygeal teratoma: evaluation of its approach, treatment and follow-up in two reference children cancer centers in Brazil / Rio de Janeiro

ABSTRACT Introduction: sacrococcygeal teratoma (TSC) is the most common tumor of the neonatal period. Alphafetoprotein is an important tumor marker and is used in the follow-up period as a marker of malignancy. The complete surgical resection of the tumor associated with coccygectomy is the standard treatment and chemotherapy in different stages are necessary. Follow-up consists of serial exam: tumor markers, imaging searching to possible metastasis sites, in addition to a complete physical examination. Methodology: a descriptive, retrospective, study was carried out by analyzing a chart of 25 patients of two different reference children cancer center; with TSC in the State of Rio de Janeiro from 2004 to 2019. The clinical and epidemiological data collected were described and a comparison was made between these two centers studied. Results: the sociodemographic characteristics found were similar to those described in the medical literature. Data related to treatment and follow-up, such as the use of chemotherapy, use of specific imaging tests, digital rectal examination, and outpatient follow-up, differed between the two centers studied. There was a 25% loss of follow-up. Conclusion: the characteristic of being a non-cancer center can interfere with the full application of the current protocol for the treatment of sacrococcygeal teratoma. The knowledge of the data of the studied cases can allow the optimization of the approach of the patients with this pathology and generate discussions about the integral application of the specific therapeutic protocol in the medical centers that are qualified for such treatment.

摘要
引言：骶尾部畸胎瘤（sacrococcygeal teratoma, TSC）是新生儿时期最常见的肿瘤。甲胎蛋白（alphafetoprotein）是重要的肿瘤标志物，在随访阶段可作为恶性状态的评估指标。完整手术切除联合尾骨切除术是标准治疗方案，不同分期的患者需辅以化疗。随访工作包括系列肿瘤标志物检测、排查潜在转移灶的影像学检查，以及全面的体格检查。

研究方法：本研究为描述性回顾性研究，对2004年至2019年间巴西里约热内卢州两家不同儿童癌症转诊中心收治的25例骶尾部畸胎瘤患者的病历进行分析。研究对收集到的临床与流行病学数据进行描述，并对两家研究中心的相关数据开展对比分析。

研究结果：本研究发现的社会人口学特征与医学文献中已报道的结果一致。两家中心在治疗与随访相关数据方面存在差异，包括化疗使用情况、特异性影像学检查应用、直肠指检及门诊随访模式。本研究的失访率为25%。

结论：非肿瘤专科中心的属性可能会干扰骶尾部畸胎瘤现行治疗方案的完整实施。本研究的病例数据可为该类患者的诊疗方案优化提供依据，并可推动具备治疗资质的医学中心就针对性治疗方案的全面落实展开讨论。