title: Function and quality-of-life of survivors of pelvic and lower extremity osteosarcoma and Ewing's sarcoma: the Childhood Cancer Survivor Study.
abstract: Limb-sparing surgeries have been performed more frequently than amputation based on the belief that limb-sparing surgeries provide improved function and quality-of-life (QOL). However, this has not been extensively studied in the paediatric population, which has unique characteristics that have implications for function and QOL. Using the Childhood Cancer Survivor Study, 528 adult long-term survivors of pediatric lower extremity bone tumours, diagnosed between 1970 and 1986, were contacted and completed questionnaries assessing function and QOL. Survivors were an average of 21 years from diagnosis with an average age of 35 years. Overall they reported excellent function and QOL. Compared to those who had a limb-sparing procedure, amputees were not more likely to have lower function and QOL scores and self-perception of disability included general health status, lower educational attainment, older age and female gender. Findings from this study suggest that, over time, amputees do as well as those who underwent limb-sparing surgeries between 1970 and 1986. However, female gender, lower educational attainment and older current age appear to influence function, QOL and disability.
authors.affiliation: Division of Pediatrics, Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Mayo Mail Code 484, 420 Delaware St., SE Minneapolis, MN 55455, USA. nagar003@umn.edu
authors.forename: R
authors.initials: R
authors.lastname: Nagarajan
authors.forename: D R
authors.initials: DR
authors.lastname: Clohisy
authors.forename: J P
authors.initials: JP
authors.lastname: Neglia
authors.forename: Y
authors.initials: Y
authors.lastname: Yasui
authors.forename: P A
authors.initials: PA
authors.lastname: Mitby
authors.forename: C
authors.initials: C
authors.lastname: Sklar
authors.forename: J Z
authors.initials: JZ
authors.lastname: Finklestein
authors.forename: M
authors.initials: M
authors.lastname: Greenberg
authors.forename: G H
authors.initials: GH
authors.lastname: Reaman
authors.forename: L
authors.initials: L
authors.lastname: Zeltzer
authors.forename: L L
authors.initials: LL
authors.lastname: Robison
mesh_terms: D000293:Adolescent; D000328:Adult; D000674:Amputees; D001859:Bone Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004493:Education; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D035002:Lower Extremity / Q000473:pathology; D008297:Male; D012516:Osteosarcoma / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D010388:Pelvis / Q000473:pathology; D011788:Quality of Life; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data