Abstract
Introduction Attempts at defining predictors of poor outcome in fetal sacrococcygeal teratoma (SCT) have been hampered by small patient numbers. We sought to validate the utility of tumor volume to fetal weight ratio (TFR) as a predictor of poor prognosis and to identify other morphological outcome predictors in a multicenter series. Methods Records of prenatally diagnosed SCT at three fetal centers from 1986 to 2011 were reviewed. Prenatal imaging characteristics including TFR, morphology, hydrops, and placentomegaly were assessed. Poor prognosis was defined as fetal demise, need for fetal intervention, or perinatal death. Receiver operating characteristic (ROC) analysis was used to select a TFR cutoff value. Results Seventy-nine fetuses with SCT were evaluated. Eleven pregnancies ending in elective termination were excluded. ROC analysis revealed that TFR > 0.12 prior to 24 weeks gestation was predictive of poor prognosis (AUC=0.913; Sensitivity=91.7%, Specificity=76.2%, PPV=86.8%; NPV=84.2%). Solid tumor morphology and presence of hydrops were found to be predictors of poor prognosis. None of the factors associated with poor prognosis were independent predictors on multivariate analysis. Conclusion This study validates TFR > 0.12 prior to 24 weeks gestation as an objective predictor of outcomes in fetuses with SCT that can be easily applied in most clinical settings.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 771-774 |
| Number of pages | 4 |
| Journal | Journal of Pediatric Surgery |
| Volume | 50 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2015 |
| Externally published | Yes |
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Keywords
- Fetal
- Outcomes
- Sacrococcygeal teratoma
- TFR
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
- Medicine(all)
Cite this
Predictors of poor prognosis in prenatally diagnosed sacrococcygeal teratoma : A multiinstitutional review. / Akinkuotu, Adesola C.; Coleman, Alan; Shue, Eveline; Sheikh, Fariha; Hirose, Shinjiro; Lim, Foong Yen; Olutoye, Oluyinka O.
In: Journal of Pediatric Surgery, Vol. 50, No. 5, 01.05.2015, p. 771-774.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predictors of poor prognosis in prenatally diagnosed sacrococcygeal teratoma
T2 - A multiinstitutional review
AU - Akinkuotu, Adesola C.
AU - Coleman, Alan
AU - Shue, Eveline
AU - Sheikh, Fariha
AU - Hirose, Shinjiro
AU - Lim, Foong Yen
AU - Olutoye, Oluyinka O.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Introduction Attempts at defining predictors of poor outcome in fetal sacrococcygeal teratoma (SCT) have been hampered by small patient numbers. We sought to validate the utility of tumor volume to fetal weight ratio (TFR) as a predictor of poor prognosis and to identify other morphological outcome predictors in a multicenter series. Methods Records of prenatally diagnosed SCT at three fetal centers from 1986 to 2011 were reviewed. Prenatal imaging characteristics including TFR, morphology, hydrops, and placentomegaly were assessed. Poor prognosis was defined as fetal demise, need for fetal intervention, or perinatal death. Receiver operating characteristic (ROC) analysis was used to select a TFR cutoff value. Results Seventy-nine fetuses with SCT were evaluated. Eleven pregnancies ending in elective termination were excluded. ROC analysis revealed that TFR > 0.12 prior to 24 weeks gestation was predictive of poor prognosis (AUC=0.913; Sensitivity=91.7%, Specificity=76.2%, PPV=86.8%; NPV=84.2%). Solid tumor morphology and presence of hydrops were found to be predictors of poor prognosis. None of the factors associated with poor prognosis were independent predictors on multivariate analysis. Conclusion This study validates TFR > 0.12 prior to 24 weeks gestation as an objective predictor of outcomes in fetuses with SCT that can be easily applied in most clinical settings.
AB - Introduction Attempts at defining predictors of poor outcome in fetal sacrococcygeal teratoma (SCT) have been hampered by small patient numbers. We sought to validate the utility of tumor volume to fetal weight ratio (TFR) as a predictor of poor prognosis and to identify other morphological outcome predictors in a multicenter series. Methods Records of prenatally diagnosed SCT at three fetal centers from 1986 to 2011 were reviewed. Prenatal imaging characteristics including TFR, morphology, hydrops, and placentomegaly were assessed. Poor prognosis was defined as fetal demise, need for fetal intervention, or perinatal death. Receiver operating characteristic (ROC) analysis was used to select a TFR cutoff value. Results Seventy-nine fetuses with SCT were evaluated. Eleven pregnancies ending in elective termination were excluded. ROC analysis revealed that TFR > 0.12 prior to 24 weeks gestation was predictive of poor prognosis (AUC=0.913; Sensitivity=91.7%, Specificity=76.2%, PPV=86.8%; NPV=84.2%). Solid tumor morphology and presence of hydrops were found to be predictors of poor prognosis. None of the factors associated with poor prognosis were independent predictors on multivariate analysis. Conclusion This study validates TFR > 0.12 prior to 24 weeks gestation as an objective predictor of outcomes in fetuses with SCT that can be easily applied in most clinical settings.
KW - Fetal
KW - Outcomes
KW - Sacrococcygeal teratoma
KW - TFR
UR - http://www.scopus.com/inward/record.url?scp=84928699680&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928699680&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2015.02.034
DO - 10.1016/j.jpedsurg.2015.02.034
M3 - Article
VL - 50
SP - 771
EP - 774
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 5
ER -