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. 2017 Feb;11(1):1-12.
doi: 10.1007/s11764-016-0556-1. Epub 2016 Jun 4.

Long-term functional outcomes and quality of life in adult survivors of childhood extremity sarcomas: a report from the St. Jude Lifetime Cohort Study

Israel Fernandez-Pineda  1 , M M Hudson  2 , A S Pappo  2 , M W Bishop  2 , J L Klosky  3 , T M Brinkman  4 , D K Srivastava  5 , M D Neel  6 , B N Rao  6 , A M Davidoff  6 , K R Krull  4 , D A Mulrooney  2 , L L Robison  4 , K K Ness  4
Affiliations

Long-term functional outcomes and quality of life in adult survivors of childhood extremity sarcomas: a report from the St. Jude Lifetime Cohort Study

Israel Fernandez-Pineda et al. J Cancer Surviv. 2017 Feb.

Abstract

Purpose: This study compared measured physical performance, health-related quality of life (HRQOL), and social role attainment between extremity sarcoma survivors and controls, and evaluated associations between disease and treatment exposures, health conditions, and performance measures.

Methods: Survivors of extremity sarcoma from the St. Jude Lifetime cohort and controls frequency matched by age-, sex-, and race completed physical performance testing and questionnaires. Survivors with Z-scores on outcome measures ≤ -2.0 SD (compared to controls) were categorized with severe impairment/limitation.

Results: Among 206 survivors (52.4 % male median age 36 years (range 19-65)), 37 % had low relative lean mass, 9.7 % had an ejection fraction <50 %, 51.5 % had diffusion capacity for carbon monoxide <75 %, 27.7 % had sensory and 25.2 % motor neuropathy, and 78.2 % had musculoskeletal complications. Severe impairments/limitations were present among ≥25 % of survivors on fitness, balance, and physical HRQOL measures, and among ≥15 % on strength and activity of daily living measures. Lower extremity tumor location (OR 8.23, 95 % CI 2.54-26.67, P value 0.0004) and amputation (OR 8.07, 95 % CI 3.06-21.27, P value <0.0001) were associated with poor fitness. Poor fitness was associated with increased odds of scoring <40 on the SF-36 physical component summary (OR 4.83, 95 % CI 1.95-11.99, P value 0.001) and role-physical subscale (OR 3.34, 95 % CI 1.33-8.43, P value 0.01). Survivors and controls had similar rates of marriage, independent living, employment, and college attendance.

Conclusions: Extremity sarcoma survivors experience high rates of physical impairment and report lower than expected physical HRQOL. However, they are as likely as peers to be married, live independently, be employed, and attend college.

Implications for cancer survivors: Follow-up for extremity sarcoma survivors should include assessment of need for further orthopedic care and rehabilitation to address cardiopulmonary and musculoskeletal health.

Keywords: Function; Musculoskeletal sarcoma; Physical performance; Quality of life; Social role attainment; Survivor.

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Conflict of interest statement

Declaration: The authors declare no competing financial interests.

References

    1. Mirabello L, Troisi RJ, Savage SA. Osteosarcoma incidence and survival rates from 1973 to 2004: data from the Surveillance, Epidemiology, and End Results Program. Cancer. 2009;115:1531–1543. - PMC - PubMed
    1. Pappo AS, Pratt CB. Soft tissue sarcomas in children. Cancer Treat Res. 1997;91:205–222. - PubMed
    1. Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, et al. SEER Cancer Statistics Review, 1975–2011. National Cancer Institute; Bethesda, MD: Apr, 2014. http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site.
    1. Denbo JW, Zhu L, Srivastava D, Stokes DC, Srinivasan S, Hudson MM, et al. Long-term pulmonary function after metastasectomy for childhood osteosarcoma: a report from the st jude lifetime cohort study. J Am Coll Surg. 2014;219:265–271. - PMC - PubMed
    1. Green DM, Kun LE, Matthay KK, Meadows AT, Meyer WH, Meyers PA, et al. Relevance of historical therapeutic approaches to the contemporary treatment of pediatric solid tumors. Pediatr Blood Cancer. 2013;60:1083–1094. - PMC - PubMed