Patient-Reported Defecation and Micturition Problems Among Adults Treated for Sacrococcygeal Teratoma During Childhood-The Need for New Surveillance Strategies

• Published in: Pediatric blood & cancer 2016-04, Vol.63 (4), p.690-694
• Main Authors: Kremer, Marijke E.B., Derikx, Joep P.M., van Baren, Robertine, Heij, Hugo A., Wijnen, Marc H.W.A., Wijnen, René M.H., van der Zee, David C., van Heurn, Ernest L.W.E.
• Format: Article
• Language: English
• Subjects: Adult; Adults; bowel function; Child, Preschool; Complaints; Constipation; Defecation; Digestive System Surgical Procedures - adverse effects; Female; germ cell tumor; Hematology; Humans; Infant; late effect of cancer treatment; Male; micturition complaints; Oncology; Patients; Pediatrics; Retrospective Studies; Sacrococcygeal Region - surgery; Surveillance; Surveys and Questionnaires; Survivors - statistics & numerical data; Teratoma - surgery; Urination Disorders - epidemiology; Urination Disorders - etiology; Urologic Surgical Procedures - adverse effects
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.25857

Background To evaluate defecation and micturition complaints in adults treated for sacrococcygeal teratoma (SCT) during childhood and to identify risk factors for soiling, urinary incontinence, and constipation beyond childhood. Procedure Records of patients aged ≥18 treated for SCT during infancy in the Netherlands were retrospectively reviewed. Frequency and severity of soiling, constipation, and urinary incontinence were evaluated using questionnaires designed in line with the Krickenbeck classification. Problems during childhood were compared to outcomes at adult age in part of the cohort. Associations between patient‐ and disease‐related factors with complaints beyond childhood were analyzed with the chi‐square test or Fisher's exact test, when appropriate. Results Of 47 included patients (mean age 26.2 years, SD ±6.5), 49% reported at least one defecation or micturition complaint. Urinary incontinence was present in 30% and had a greater negative impact than soiling (24%). Ten patients (21%) reported constipation; five found this severely bothering. Three patients reported social restrictions due to defecation or micturition complaints (6.4%). While sex and tumor histology were not identified as risk factors, a tumor diameter of >10 cm and Altman type I or type II SCT were associated with constipation during adulthood. Conclusions One‐third of the patients treated for SCT during childhood reported urinary and defecation problems beyond childhood. In only a minority of cases, these led to social restrictions. A greater tumor diameter was associated with a higher risk of constipation during adulthood. Prolonged surveillance strategies are advised for all patients with SCT.