- Surgical resection provides durable outcomes
A 5-year recurrence-free survival rate of 98% and a low recurrence rate (3.4%) support surgery as the primary treatment approach. - Most retrorectal tumors are benign and incidentally detected
Approximately 95% of tumors were benign, and 93% were identified incidentally on imaging. - Posterior approach is most commonly used
The surgical approach was guided by tumor location relative to the third sacral vertebra, with 91% managed via a posterior approach. - Preoperative biopsy should be selective
Biopsy was associated with a higher rate of complications (29% vs 4%) without a statistically significant difference overall, suggesting limited routine value. - Complete excision and long-term follow-up are critical
Rare cases of recurrence and malignant transformation underscore the importance of complete initial resection and continued surveillance.
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