Quality of life after bone sarcoma surgery around the knee: A long-term follow-up study

Abstract

It remains unclear if quality of life (QoL) improvements could be expected in young patients after malignant bone tumour surgery after 2 years. To assess the course of QoL over time during a long-term follow-up, malignant bone tumour survivors of a previous short-term study were included. Assessments were done at least 5 years patients; 20 patients were included for this study, 10 males; mean age at surgery 15.1 years and mean follow-up 7.2 years. Twenty-one patients of the initial cohort (47%) deceased. Fifteen patients (75%) underwent limb-salvage and five (25%) ablative surgery. QoL improved significantly during follow-up at Physical Component Summary Scale scale of the SF-36 and TAAQOL and all subscales of the Bt-DUX (p < .01). No significant differences were found between current evaluations and previous evaluations at 2 years after surgery (p = .41-.98). Significant advantages after limb-salvage were seen at the PCS scale of the SF-36 (MD 13.7, p = .05) and the cosmetic scale of the Bt-DUX (MD 17.7, p = .04). K E Y W O R D Sadolescents, children, leg, malignant bone tumour, prospective, quality of life Wang, & Bi, 2012; Hinds et al., 2009;Koopman et al., 2005;Liu et al., 2014). Therefore, we evaluated a few years ago QoL levels at six time points of a cohort of children and adolescents under the age of 25 after malignant bone tumour surgery of the lower limb. In this previous study, improvements of QoL levels were reported from surgery up to 24 months thereafter and were most pronounced and significant over the first year after the surgery. Over the second year improvements became smaller and the differences between QoL scores at 1 and 2 years after surgery were mostly non-significant . However, QoL scores still differed from scores of healthy peers and it remains unclear if further improvements could be expected after this period. Therefore, the aim of this study was to assess the course of QoL over time between 2 and 5 years or more after surgery. | MATERIALS AND METHODS | Study design and patient recruitmentThe study had a prospective and multi-centre design. All consecutive patients who underwent a surgical intervention due to a bone sarcoma around the knee joint in one of three university medical cen- | Assessment methodsAssessments included; questionnaires concerning QoL which were sent by post and an interview with the investigators (PB and JvE).Patients' baseline socio-demographic (Table 1)

Body image, self-esteem, and quality of life in patients with primary malignant bone tumors

“…Similar to the current study, categories depicting psychological health and social function were not influenced [6]. Other studies emphasized the trend that was found [8,19]. Both studies investigated QoL in young patients with bone tumors using the SF-36 and observed that QoL is inferior regarding physical health compared to control.…”

“…Both studies investigated QoL in young patients with bone tumors using the SF-36 and observed that QoL is inferior regarding physical health compared to control. However, both could not find a psychological influence on QoL [8,19]. However, both these studies included only young patients in their cohorts.…”

“…Currently, the literature referring to social and psychological effects in patients with primary malignant bone tumors is limited. Some studies aimed to evaluate QoL in patients with primary bone tumors [6][7][8]. Other studies aimed to assess the body image of tumor patients [9,10].…”

Qualitative study exploring patients experiences of being diagnosed and living with primary bone cancer in the UK

“…This was, for some, more straightforward due to their personality and/or timely professional and informal support available. But this might also reflect Bekkering’s et al 36 suggestion that similar psychological status of patients with sarcoma and healthy peers found in their study was due to positive emotions felt after completion of treatment and survival, in what was termed the ‘response shift’.…”

The Italian consensus conference on the role of rehabilitation for children and adolescents with leukemia, central nervous system, and bone tumors, part 1: Review of the conference and presentation of consensus statements on rehabilitative evaluation of motor aspects

“…Some of the most pertinent reference values for the first-year postsurgical treatment for patients with mega-prosthesis of the knee are as follows: the possibility of recovering 90 • of knee flexion in 50% of the patients, 3 months after surgery; for quadricep strength recovery in 25% of patients, 12 months after surgery, the values are less than three according to the manual muscle test (0-5) 56 but with the chance of improving motor function even 12-24 months postsurgery. 57,58 Beyond the oncological phases, further assessments are carried out periodically by the physiotherapist to monitor progress. This assessment is done at the beginning and at the end of the rehabilitation process, and also when clinical conditions change.…”