Factors influencing quality of life, function, reintegration and participation after musculoskeletal tumour operations

BMC Cancer. 2020 Apr 25;20(1):351. doi: 10.1186/s12885-020-06837-x.

Abstract

Background: The number of people living with soft-tissue and bone sarcomas is increasing due to improved individual therapy and changes in demographics. At present, there are no recommendations for psychological co-treatment, occupational and social reintegration following the treatment of soft tissue and bone sarcomas.

Methods: Seventy-four patients, 42 males and 32 females, aged between 18 and 80 years (54.58 ± 16.99 yr.) with soft-tissue (62) and bone sarcomas (12) were included to answer five standardized and one personal questionnaire regarding quality of life, function, reintegration and participation after surgical treatment.

Results: A number of tumour-specific and patient-specific factors were identified that affected the therapeutic outcome. Patients with sarcoma of the lower extremity described poorer mobility. Patients who underwent amputation reported a higher anxious preoccupation. Patients with a higher range of education were less fatalistic and avoiding. The size of tumours or additive radiation therapy did not affect the post-therapeutic quality of life, coping and function. There was a good correlation between anxiety and depression with occupational reintegration, function, quality of life and coping.

Conclusion: Patients with sarcomas of the lower limb have a higher demand for postoperative rehabilitation and need more help in the postoperative occupational reintegration. Furthermore patients that underwent limb-preserving operations reported better postoperative function and quality of life. Risk assessment using patient-specific factors and an intensive psychological co-treatment may have a large role in the co-treatment of patients from the beginning of their cancer therapy.

Keywords: Ablative surgery; Amputation; Anxiety; Depression; Operation; Quality of life; Sarcoma.

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical / psychology*
  • Amputation, Surgical / rehabilitation*
  • Bone Neoplasms / pathology
  • Bone Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Muscle Neoplasms / pathology
  • Muscle Neoplasms / surgery*
  • Osteosarcoma / pathology
  • Osteosarcoma / surgery
  • Prognosis
  • Quality of Life*
  • Retrospective Studies
  • Return to Work / psychology*
  • Sarcoma / pathology
  • Sarcoma / surgery
  • Surveys and Questionnaires
  • Young Adult