Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas: Cohort study and literature review

N. Sananes, P. Javadian, I. Schwach Werneck Britto, N. Meyer, A. Koch, A. Gaudineau, R. Favre, Rodrigo Ruano

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Objectives The objectives of this study were to evaluate the efficacy of minimally invasive ablation of high-risk large sacrococcygeal teratomas (SCT) and to compare the efficacy of vascular and interstitial tumor ablation. Methods This was a retrospective multicenter study including a cohort of fetuses with high-risk large SCTs between 2004 and 2010. In addition, we performed a systematic literature review of all cases that underwent tumor ablation in order to compare the survival rates after 'vascular' and 'interstitial' ablation. Statistical analysis was conducted using Bayesian methods. Results In our cohort, a total of 13 fetuses had high-risk large SCT and five of them underwent tumor ablation. The estimated difference in hydrops resolution rate between the fetal intervention and the no fetal intervention groups was 44.6% (95% credibility interval, 1.5 to 81.0%; Pdiff> 0 = 97.9%). The estimated difference in survival rate between the fetal intervention and the no fetal intervention groups was 31.0% (13.9 to 48.1%; Pdiff> 0 = 99.9%). We analyzed our five cases together with 28 cases from the literature and estimated the difference in survival rate between the vascular and interstitial ablation groups as 19.8% (-13.1 to 50.1%; Pdiff> 0 = 88.3%). The estimated difference in hydrops resolution rate between the vascular and the interstitial ablation groups was 36.7% (-5.7 to 72.7%; Pdiff> 0 = 95.5%). Conclusion Minimally invasive surgery seems to improve perinatal outcome in cases of high-risk large fetal SCT. Our findings suggest that 'vascular' ablation may improve outcome and may be more effective than 'interstitial' tumor ablation, but this hypothesis needs further investigation in a larger multicenter prospective study.

Original languageEnglish (US)
Pages (from-to)712-719
Number of pages8
JournalUltrasound in Obstetrics and Gynecology
Volume47
Issue number6
DOIs
StatePublished - Jun 1 2016
Externally publishedYes

Fingerprint

Fetal Therapies
Teratoma
Blood Vessels
Cohort Studies
Multicenter Studies
Edema
Neoplasms
Fetus
Bayes Theorem
Minimally Invasive Surgical Procedures
Retrospective Studies
Prospective Studies

Keywords

  • Fetal surgery
  • Sacrococcygeal teratoma
  • Tumor interstitial ablation
  • Vascular ablation

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

Cite this

Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas : Cohort study and literature review. / Sananes, N.; Javadian, P.; Schwach Werneck Britto, I.; Meyer, N.; Koch, A.; Gaudineau, A.; Favre, R.; Ruano, Rodrigo.

In: Ultrasound in Obstetrics and Gynecology, Vol. 47, No. 6, 01.06.2016, p. 712-719.

Research output: Contribution to journalReview article

Sananes, N. ; Javadian, P. ; Schwach Werneck Britto, I. ; Meyer, N. ; Koch, A. ; Gaudineau, A. ; Favre, R. ; Ruano, Rodrigo. / Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas : Cohort study and literature review. In: Ultrasound in Obstetrics and Gynecology. 2016 ; Vol. 47, No. 6. pp. 712-719.
@article{4ae154b4df7645ca81179edfe39b8d92,
title = "Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas: Cohort study and literature review",
abstract = "Objectives The objectives of this study were to evaluate the efficacy of minimally invasive ablation of high-risk large sacrococcygeal teratomas (SCT) and to compare the efficacy of vascular and interstitial tumor ablation. Methods This was a retrospective multicenter study including a cohort of fetuses with high-risk large SCTs between 2004 and 2010. In addition, we performed a systematic literature review of all cases that underwent tumor ablation in order to compare the survival rates after 'vascular' and 'interstitial' ablation. Statistical analysis was conducted using Bayesian methods. Results In our cohort, a total of 13 fetuses had high-risk large SCT and five of them underwent tumor ablation. The estimated difference in hydrops resolution rate between the fetal intervention and the no fetal intervention groups was 44.6{\%} (95{\%} credibility interval, 1.5 to 81.0{\%}; Pdiff> 0 = 97.9{\%}). The estimated difference in survival rate between the fetal intervention and the no fetal intervention groups was 31.0{\%} (13.9 to 48.1{\%}; Pdiff> 0 = 99.9{\%}). We analyzed our five cases together with 28 cases from the literature and estimated the difference in survival rate between the vascular and interstitial ablation groups as 19.8{\%} (-13.1 to 50.1{\%}; Pdiff> 0 = 88.3{\%}). The estimated difference in hydrops resolution rate between the vascular and the interstitial ablation groups was 36.7{\%} (-5.7 to 72.7{\%}; Pdiff> 0 = 95.5{\%}). Conclusion Minimally invasive surgery seems to improve perinatal outcome in cases of high-risk large fetal SCT. Our findings suggest that 'vascular' ablation may improve outcome and may be more effective than 'interstitial' tumor ablation, but this hypothesis needs further investigation in a larger multicenter prospective study.",
keywords = "Fetal surgery, Sacrococcygeal teratoma, Tumor interstitial ablation, Vascular ablation",
author = "N. Sananes and P. Javadian and {Schwach Werneck Britto}, I. and N. Meyer and A. Koch and A. Gaudineau and R. Favre and Rodrigo Ruano",
year = "2016",
month = "6",
day = "1",
doi = "10.1002/uog.14935",
language = "English (US)",
volume = "47",
pages = "712--719",
journal = "Ultrasound in Obstetrics and Gynecology",
issn = "0960-7692",
publisher = "John Wiley and Sons Ltd",
number = "6",

}

TY - JOUR

T1 - Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas

T2 - Cohort study and literature review

AU - Sananes, N.

AU - Javadian, P.

AU - Schwach Werneck Britto, I.

AU - Meyer, N.

AU - Koch, A.

AU - Gaudineau, A.

AU - Favre, R.

AU - Ruano, Rodrigo

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Objectives The objectives of this study were to evaluate the efficacy of minimally invasive ablation of high-risk large sacrococcygeal teratomas (SCT) and to compare the efficacy of vascular and interstitial tumor ablation. Methods This was a retrospective multicenter study including a cohort of fetuses with high-risk large SCTs between 2004 and 2010. In addition, we performed a systematic literature review of all cases that underwent tumor ablation in order to compare the survival rates after 'vascular' and 'interstitial' ablation. Statistical analysis was conducted using Bayesian methods. Results In our cohort, a total of 13 fetuses had high-risk large SCT and five of them underwent tumor ablation. The estimated difference in hydrops resolution rate between the fetal intervention and the no fetal intervention groups was 44.6% (95% credibility interval, 1.5 to 81.0%; Pdiff> 0 = 97.9%). The estimated difference in survival rate between the fetal intervention and the no fetal intervention groups was 31.0% (13.9 to 48.1%; Pdiff> 0 = 99.9%). We analyzed our five cases together with 28 cases from the literature and estimated the difference in survival rate between the vascular and interstitial ablation groups as 19.8% (-13.1 to 50.1%; Pdiff> 0 = 88.3%). The estimated difference in hydrops resolution rate between the vascular and the interstitial ablation groups was 36.7% (-5.7 to 72.7%; Pdiff> 0 = 95.5%). Conclusion Minimally invasive surgery seems to improve perinatal outcome in cases of high-risk large fetal SCT. Our findings suggest that 'vascular' ablation may improve outcome and may be more effective than 'interstitial' tumor ablation, but this hypothesis needs further investigation in a larger multicenter prospective study.

AB - Objectives The objectives of this study were to evaluate the efficacy of minimally invasive ablation of high-risk large sacrococcygeal teratomas (SCT) and to compare the efficacy of vascular and interstitial tumor ablation. Methods This was a retrospective multicenter study including a cohort of fetuses with high-risk large SCTs between 2004 and 2010. In addition, we performed a systematic literature review of all cases that underwent tumor ablation in order to compare the survival rates after 'vascular' and 'interstitial' ablation. Statistical analysis was conducted using Bayesian methods. Results In our cohort, a total of 13 fetuses had high-risk large SCT and five of them underwent tumor ablation. The estimated difference in hydrops resolution rate between the fetal intervention and the no fetal intervention groups was 44.6% (95% credibility interval, 1.5 to 81.0%; Pdiff> 0 = 97.9%). The estimated difference in survival rate between the fetal intervention and the no fetal intervention groups was 31.0% (13.9 to 48.1%; Pdiff> 0 = 99.9%). We analyzed our five cases together with 28 cases from the literature and estimated the difference in survival rate between the vascular and interstitial ablation groups as 19.8% (-13.1 to 50.1%; Pdiff> 0 = 88.3%). The estimated difference in hydrops resolution rate between the vascular and the interstitial ablation groups was 36.7% (-5.7 to 72.7%; Pdiff> 0 = 95.5%). Conclusion Minimally invasive surgery seems to improve perinatal outcome in cases of high-risk large fetal SCT. Our findings suggest that 'vascular' ablation may improve outcome and may be more effective than 'interstitial' tumor ablation, but this hypothesis needs further investigation in a larger multicenter prospective study.

KW - Fetal surgery

KW - Sacrococcygeal teratoma

KW - Tumor interstitial ablation

KW - Vascular ablation

UR - http://www.scopus.com/inward/record.url?scp=84971507061&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84971507061&partnerID=8YFLogxK

U2 - 10.1002/uog.14935

DO - 10.1002/uog.14935

M3 - Review article

C2 - 26138446

AN - SCOPUS:84971507061

VL - 47

SP - 712

EP - 719

JO - Ultrasound in Obstetrics and Gynecology

JF - Ultrasound in Obstetrics and Gynecology

SN - 0960-7692

IS - 6

ER -