title: Young survivors of malignant bone tumours in the extremities: a comparative study of quality of life, fatigue and mental distress.
abstract: OBJECTIVE
  The purpose of the study was to compare the quality of life (QoL), fatigue and mental distress in survivors of malignant extremity bone tumours (EBT survivors) with age and gender-matched survivors of Hodgkin's disease (HD survivors) and testicular cancer (TC survivors) as well as normative samples from the general population.
  
  
  METHODS
  Five years or more after end of treatment, 75 EBT survivors were mailed a questionnaire containing Short Form-36 (SF-36), the Hospital Anxiety and Depression Scale, the Fatigue Questionnaire and questions about demography. Fifty-eight EBT survivors responded. TC survivors, HD survivors and normative samples (NORMs) had earlier on filled in the same questionnaire. For EBT survivors, gender and age-matched controls were randomly selected among TC survivors, HD survivors and NORMs.
  
  
  RESULTS
  No significant differences in the fatigue or mental distress scores were observed between the survivor groups. The EBT survivors had significantly higher fatigue scores and lower depression scores than NORMs and significantly lower scores on all physical dimensions of QoL than TC survivors, HD survivors and NORMs. In multivariate analysis, a low level of education and lack of employment were significantly associated with caseness of mental distress. Older age at survey, female gender, being an EBT survivor and lack of employment were associated with caseness on the SF-36 Physical Component Summary Scale.
  
  
  CONCLUSIONS
  At long-term follow-up, EBT survivors did not show impaired mental health or fatigue at the group level, although their post-treatment status was characterised by reduced QoL dimensions on physical function compared to TC survivors, HD survivors and NORMs.
authors.affiliation: The Cancer Clinic, Department of Oncology, Rikshospitalet-Radiumhospitalet Medical Center, University of Oslo, Montebello, 0310 Oslo, Norway. liv.hege.aksnes@radiumhospitalet.no
authors.forename: Liv Hege
authors.initials: LH
authors.lastname: Aksnes
authors.forename: Kirsten Sundby
authors.initials: KS
authors.lastname: Hall
authors.forename: Nina
authors.initials: N
authors.lastname: Jebsen
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
authors.forename: Alv A
authors.initials: AA
authors.lastname: Dahl
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000150:complications / Q000523:psychology*; D002648:Child; D005121:Extremities; D005221:Fatigue / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013315:Stress, Psychological / Q000209:etiology*; D017741:Survivors / Q000523:psychology*