Correlation of continence with long-term patient centered outcomes in children with sacrococcygeal teratoma

Purpose: The purpose of this study is to evaluate the relationship of social continence with patient centered outcomes, such as quality of life, in children with sarococcygeal teratoma (SCT). We hypothesize there is a correlation between social continence and patient-centered outcomes.

Methods: A chart review and three surveys (Pediatric Quality of Life Inventory™ (PedsQL™), Baylor Continence Scale (BCS), and Impact on Family (IOF)) were performed for SCT patients who underwent resection at our institution from 2013 to 2018. PedsQL™ assesses quality of life, BCS evaluates global continence, and the IOF scale measures the impact of a child's illness on the family. Pearson correlation was used to examine the relationship between BCS, PedsQL™, and IOF.

Results: Eighteen patients were identified with 72% (13/18) participating in the surveys with a median age at time of survey of 4.7 years (range 2.8-7.9). Patients with Altman IV were diagnosed postnatally and had smaller tumors. At the time of survey administration, a majority of children were toilet trained (54%, 7/13). Parents reported urinary incontinence (46%, 6/13) more frequently than bowel incontinence (15%, 2/13). Altman III/IV trended towards worse PedsQL™, BCS, and IOF surveys; however, it was not significant. The BCS correlated with the Total PedsQL™ (ρ = -0.56, p = 0.048) and IOF (ρ = 0.68, p = 0.011).

Conclusion: Children with SCT have a correlation between social continence, quality of life, and the impact on family. This study suggests interventions to screen and improve continence in children with SCT could also improve patient centered metrics.

Study design: Cross-sectional study LEVEL OF EVIDENCE: Level II, Prognosis Study.