Prognostic accuracy of factors associated with poor outcome in prenatally diagnosed sacrococcygeal teratoma: A systematic review and meta-analysis |
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| Authors: | Lieke J van Heurn Audrey Coumans Monique C Haak Annemarth van der Kaaij L W Ernest van Heurn Eva Pajkrt Joep P M Derikx |
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| Institution: | 1. Emma Children's Hospital, University of Amsterdam & Vrije Universiteit Amsterdam, Department of P(a)ediatric Surgery, Amsterdam UMC, Amsterdam, The Netherlands;2. Department of Obstetrics and Gynaecology, Maastricht UMC+, Maastricht, The Netherlands;3. Department Obstetrics & Gynaecology, Division of Fetal Medicine, Leiden University Medical Center, Leiden, The Netherlands;4. Leiden University Medical Center, Leiden, The Netherlands;5. Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam Department of Obstetrics, Amsterdam, The Netherlands |
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| Abstract: | Several factors associated with poor outcome in patients with prenatally diagnosed sacrococcygeal teratoma (SCT) have been found. However, the prognostic accuracy of these factors has not been well established. Therefore, we aimed to systematically review the prognostic accuracy of factors associated with poor outcome in these patients. We queried Search Premier, COCHRANE Library, EMCARE, EMBASE, PubMed, ScienceDirect, and Web of Science databases to identify studies regarding patients with prenatally diagnosed SCT. Poor outcome was defined as termination of pregnancy (TOP), intrauterine fetal death (IUFD), or perinatal death. We estimated the odds ratio of factors associated with poor outcome. Eleven studies (447 patients) were included. Overall mortality, including TOP, was 34.9%. Factors associated with poor outcome in fetuses with prenatally diagnosed SCT were cardiomegaly, hypervascular tumor, solid tumor morphology, fetal hydrops, and placentomegaly. A tumor volume to fetal weight ratio (TFR) of >0.12 before a gestational age of 24 weeks is predictive of poor outcome. The prognostic accuracy of factors associated with poor outcome in fetuses prenatally diagnosed with SCT seems promising. Factors associated with cardiac failure such as cardiomegaly, hypervascular tumor, solid tumor morphology, fetal hydrops, placentomegaly, and TFR >0.12 were found to be predictive of poor outcome. |
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