Predictors of poor prognosis in prenatally diagnosed sacrococcygeal teratoma

A multiinstitutional review

Adesola C. Akinkuotu, Alan Coleman, Eveline Shue, Fariha Sheikh, Shinjiro Hirose, Foong Yen Lim, Oluyinka O. Olutoye

Research output: Contribution to journalArticle

19 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)771-774
Number of pages4
JournalJournal of Pediatric Surgery
Volume50
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

Fingerprint

Fetal Weight
Teratoma
Fetal Death
ROC Curve
Pregnancy
Edema
Fetus
Tumor Burden
Area Under Curve
Multivariate Analysis
Sensitivity and Specificity
Neoplasms

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 journalArticle

Akinkuotu, Adesola C. ; Coleman, Alan ; Shue, Eveline ; Sheikh, Fariha ; Hirose, Shinjiro ; Lim, Foong Yen ; Olutoye, Oluyinka O. / Predictors of poor prognosis in prenatally diagnosed sacrococcygeal teratoma : A multiinstitutional review. In: Journal of Pediatric Surgery. 2015 ; Vol. 50, No. 5. pp. 771-774.
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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.",
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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.

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