Japanese clinical practice guidelines for sacrococcygeal teratoma, 2017

  • Shigehisa Fumino
    Department of Pediatric Surgery Kyoto Prefectural University of Medicine Kyoto Japan
  • Tatsuro Tajiri
    Department of Pediatric Surgery Kyoto Prefectural University of Medicine Kyoto Japan
  • Noriaki Usui
    Department of Pediatric Surgery Osaka Women's and Children's Hospital Osaka Japan
  • Masanori Tamura
    Department of Pediatrics Saitama Medical Center Saitama Medical University Saitama Japan
  • Haruhiko Sago
    Department of Maternal–Fetal and Neonatal Medicine National Center for Child Health and Development Tokyo Japan
  • Shigeru Ono
    Department of Pediatric Surgery Jichi Children's Medical Center Tochigi Jichi Medical University Tochigi Japan
  • Shunsuke Nosaka
    Division of Radiology National Center for Child Health and Development Tokyo Japan
  • Akihiro Yoneda
    Department of Pediatric Surgery Osaka City General Hospital Osaka Japan
  • Ryota Souzaki
    Department of Pediatric Surgery Graduate School of Medical Sciences Kyushu University Fukuoka Japan
  • Mayumi Higashi
    Department of Pediatric Surgery Kyoto Prefectural University of Medicine Kyoto Japan
  • Kohei Sakai
    Department of Pediatric Surgery Kyoto Prefectural University of Medicine Kyoto Japan
  • Ken Takahashi
    Department of Obstetrics and Gynecology Jikei University School of Medicine Tokyo Japan
  • Takahiro Sugiura
    Department of Pediatrics Toyohashi Municipal Hospital Aichi Japan
  • Tomoaki Taguchi
    Department of Pediatric Surgery Graduate School of Medical Sciences Kyushu University Fukuoka Japan

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Abstract

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Sacrococcygeal teratoma (<jats:styled-content style="fixed-case">SCT</jats:styled-content>) is the most common extragonadal germ cell tumor in neonates and infants. Although most cases of infantile <jats:styled-content style="fixed-case">SCT</jats:styled-content> are benign tumors by nature, some develop into extremely large lesions, leading to massive bleeding, high‐output heart failure, disseminated intravascular coagulation, and even fatal outcomes during the neonatal period. In addition, some patients may present with tumor recurrence, malignant transformation, long‐term sequelae (including bladder and bowel dysfunction) and lower leg palsy during the long‐term follow up. <jats:styled-content style="fixed-case">SCT</jats:styled-content>, however, is very rare, and there are few opportunities to encounter this disease, therefore general physicians without expert credentials currently lack information relevant to clinical practice. For this reason, the research project committee has compiled guidelines concerning <jats:styled-content style="fixed-case">SCT</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The purpose of these guidelines was to share information concerning the treatment and follow up of infantile <jats:styled-content style="fixed-case">SCT</jats:styled-content>. The guidelines were developed using the methodologies in the Medical Information Network Distribution System. A comprehensive search of the English‐ and Japanese‐language articles in PubMed and Ichu‐Shi Web identified only case reports or case series, and the recommendations were developed through a process of informal consensus.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The clinical questions addressed the risk factors, the efficacy of cesarean section, the initial devascularization of tumor feeding vessels, interventional radiology, recommended clinical studies for follow up and possible long‐term complications.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>These are the first guidelines for <jats:styled-content style="fixed-case">SCT</jats:styled-content> to be established in Japan, and they may have huge clinical value and significance in terms of developing therapeutic strategies and follow up, potentially contributing to the improvement of the prognosis and quality of life of <jats:styled-content style="fixed-case">SCT</jats:styled-content> patients.</jats:p></jats:sec>

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