The impact of mid- and late-stage teratoma on human life span

Once a teratoma is diagnosed, early surgical resection is necessary to prevent the malignant transformation of benign teratoma due to delayed surgery, and to prevent infection, rupture, bleeding and complications. The key point of teratoma surgery is to completely remove the tumor. For ovarian and testicular tumors, one ovary or testicle should be removed. For sacrococcygeal teratoma, it is emphasized that the coccyx must be removed at the same time to avoid residual pluripotent cells and tumor recurrence. Does the middle and late stage of teratoma have an impact on human life expectancy?

The treatment principle of malignant teratoma is combined adjuvant therapy. Conventional chemotherapy is used for 1.5 to 2 years after surgical resection. Cisplatin, vinblastine or vincristine, and bleomycin are commonly used. In recent years, it is recommended to use cisplatin, doxorubicin, ifosfamide and other chemotherapy drugs for combined chemotherapy. Radiotherapy is only used for cases of malignant teratoma with clear microscopic or macroscopic residues. The radiotherapy dose is preferably 25Gy for microscopic residues, and 35Gy can be used for macroscopic residues. For those with complete surgical resection, chemotherapy is advocated as the main treatment, and radiotherapy is used with caution to avoid delayed damage to reproductive organs and bone development during radiotherapy. However, there is a new radiotherapy technology called intensity-modulated radiotherapy, which can effectively reduce side effects and is more effective than traditional radiotherapy. However, this technology tests the advanced nature of the equipment and the clinical experience of the radiotherapy doctor.
For patients with large or extensively infiltrated malignant teratomas that are clinically judged to be unresectable, preoperative chemotherapy or radiotherapy can be used to shrink the tumor before delayed radical surgery, which is of positive significance in improving the surgical resection rate and preserving important organs. For advanced cases, preoperative chemotherapy or radiotherapy can also achieve the therapeutic purpose of relieving tumor compression, controlling metastatic lesions, and gaining the opportunity for another surgery.
The prognosis of teratoma is closely related to factors such as the age of first diagnosis, tumor location, incidence of malignant transformation, and treatment results. The younger the age of first diagnosis, the lower the incidence of malignancy. Among them, the malignancy rate of occult teratoma is the highest, reaching 71.4%; the mixed type is 46.7%, and the overt type is only 9.4%.
Complete removal of the tumor and reduction of postoperative recurrence and malignant transformation are another major prognostic factor for teratoma. Even for malignant teratoma, complete surgical resection is still the basic guarantee for long-term survival. At present, the three-year survival rate of comprehensive treatment after complete resection of malignant teratoma can reach 50%, and the five-year survival rate is 35%, while the survival rate of residual or recurrent tumors during surgery is only 3%. Among them, the survival rate of malignant teratomas in parts that are easy to completely remove, such as testicles and ovaries, is significantly higher than that of retroperitoneal and sacrococcygeal malignant teratomas. Among them, the prognosis of occult sacrococcygeal malignant teratomas is the worst, with a survival rate of only 8%.