Di Zhang1,2, Yizhou Sun1,2, Lei Lian1,2, Bang Hu1,2, Heng Zhang1,2, Qi Zou1,2, Dandan Huang1,2, Donglin Ren1,2. 1. Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China. 2. Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Abstract
BACKGROUND: The incidence of presacral tumours is low and pertinent data are sparse on the management and outcomes after surgery. The aim of the study was to identify the risk factors of recurrence in patients with presacral tumours undergoing surgery at our institution. METHODS: Patients undergoing presacral tumour resection between 2009 and 2019 were identified from a prospectively maintained database. Demographics, clinicopathological features, preoperative imaging, operative details, morbidity, mortality, recurrence, and survival were investigated. RESULTS: A total of 122 patients were identified. There were 95 females (77.9 %), and the median age was 34 years. The most common presenting symptoms included pelvic pain (n = 60, 49.2%) and recurrent abscesses or fistulas (n = 40, 32.8%). The accuracy of preoperative magnetic resonance imaging (MRI) in distinguishing malignant from benign tumours was 93.9%. Six patients underwent three-dimensional computed tomography angiography (3D-CTA) and preoperative interventional embolization. Procedures were performed using transabdominal (n = 9), posterior (n = 99), and combined abdominal and posterior (n = 14) approaches. There were 21 (17.2 %) malignant and 101 (82.8 %) benign tumours. Local recurrence rate was 33.3% for malignant and 9.9% for benign tumours. Multivariate analysis revealed that the recurrence of malignant tumours was associated with R1 resection, while the recurrence of benign tumours was associated with secondary resections and intraoperative lesion rupture. CONCLUSION: Presacral tumours continue to be a diagnostic and therapeutic challenge. A multidisciplinary team, based on modern imaging modalities, is essential for the management of presacral tumours. This article is protected by copyright. All rights reserved.
BACKGROUND: The incidence of presacral tumours is low and pertinent data are sparse on the management and outcomes after surgery. The aim of the study was to identify the risk factors of recurrence in patients with presacral tumours undergoing surgery at our institution. METHODS:Patients undergoing presacral tumour resection between 2009 and 2019 were identified from a prospectively maintained database. Demographics, clinicopathological features, preoperative imaging, operative details, morbidity, mortality, recurrence, and survival were investigated. RESULTS: A total of 122 patients were identified. There were 95 females (77.9 %), and the median age was 34 years. The most common presenting symptoms included pelvic pain (n = 60, 49.2%) and recurrent abscesses or fistulas (n = 40, 32.8%). The accuracy of preoperative magnetic resonance imaging (MRI) in distinguishing malignant from benign tumours was 93.9%. Six patients underwent three-dimensional computed tomography angiography (3D-CTA) and preoperative interventional embolization. Procedures were performed using transabdominal (n = 9), posterior (n = 99), and combined abdominal and posterior (n = 14) approaches. There were 21 (17.2 %) malignant and 101 (82.8 %) benign tumours. Local recurrence rate was 33.3% for malignant and 9.9% for benign tumours. Multivariate analysis revealed that the recurrence of malignant tumours was associated with R1 resection, while the recurrence of benign tumours was associated with secondary resections and intraoperative lesion rupture. CONCLUSION: Presacral tumours continue to be a diagnostic and therapeutic challenge. A multidisciplinary team, based on modern imaging modalities, is essential for the management of presacral tumours. This article is protected by copyright. All rights reserved.