title: Health related quality of life in adolescent and young adult survivors of lower extremity bone tumors.
abstract: BACKGROUND
  Dramatic increases in survival rates have led to increased interest regarding the health related quality of life (HRQOL) of adolescent and young adult survivors of bone tumors. This study investigated HRQOL and physical disability in adolescent and young adult survivors of lower extremity bone tumors as a function of type of surgical intervention, gender, and age at assessment.
  
  
  METHODS
  Twenty-eight participants (age range 18-32 years) completed three generic and one disease-specific measures of HRQOL and a measure of physical disability. For analysis, surgical intervention was grouped into limb sparing surgeries (LS; allograft fusion and endoprosthesis) and ablative surgeries (AMP; amputation or Van Nes rotationplasty). Age at study was grouped into ≤ 25 years of age and ≥ 26 years of age. The MOS-SF-36, HUI2, HUI3, and EORTC-QLQ-C30 were used to measure HRQOL and the TESS was used to assess physical disability.
  
  
  RESULTS
  Survivors reported HRQOL equivalent to the general population, with the exception of physical functioning. LS reported poorer HRQOL than AMP participants for emotional functioning and fatigue. Males reported better HRQOL compared with females for overall HRQOL, general health, physical functioning, and social functioning. Finally, younger participants generally reported better HRQOL than older participants for overall HRQOL and physical functioning.
  
  
  CONCLUSIONS
  This study identifies LS surgical intervention, female gender and older age as risk factors for reduced HRQOL in adolescent and young adult survivors of lower extremity bone tumors. This study also provides information about what instrument may be most useful in identifying these specific difficulties and subgroups.
authors.affiliation: Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada. maru.barrera@sickkids.ca
authors.forename: Maru
authors.initials: M
authors.lastname: Barrera
authors.forename: Tanya
authors.initials: T
authors.lastname: Teall
authors.forename: Ronald
authors.initials: R
authors.lastname: Barr
authors.forename: Mariana
authors.initials: M
authors.lastname: Silva
authors.forename: Mark
authors.initials: M
authors.lastname: Greenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001859:Bone Neoplasms / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D050281:Bones of Lower Extremity / Q000601:surgery*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires; D015996:Survival Rate; D017741:Survivors; D055815:Young Adult