骶尾部畸胎瘤预后因素探讨

Analysis of the Prognosis of Sacrococcygeal Teratoma

101例骶尾部畸胎瘤良性75.2%、恶性24.8%.总随访率74.3%.恶性率1岁以内7.6%,1～2岁63.2%,2岁以后不随年龄上升.良性复发率12.3%,复发后71%为恶性.恶性病例中位生存期8个月,复发后生存期平均4个月.分析提示延迟诊断是导致恶性率上升的重要原因,手术切除的完整性是减少肿瘤复发和恶交的关键,联合辅助治疗能提高恶性病例的疗效.

101 cases of sacrococcygeal teratoma were reviewed.Of them,25.8% were malignant and 74.3% were followed up.The pathology,operation age,clinical type and treatment were discussed.7.6% were malignant in patients aged younger than one year while 63.2% in those aged 1-2 years,and the incidence of malignancy remained unchange after 2 years of age.Recurrence occured in 12.3% of benign cases with incomplate removal and in 71% of malignant.Benign cases usually recurred within 2 years after operation,so the first follow up should not be later than this time.The average survival time was 8 months among the malignant cases and was 4 months among recurred cases.A complete removal of the tumor with the coccyx in the initial operation is the key to reduce the recurrence and malignant change.Surgery combined with chemotherapy and radiotherapy is suggested to improve the prognosis.