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. 1997 Mar;1(1):39–45. doi: 10.1080/13577149778461

Quality of Life in Children Following Treatment for a Malignant Primary Bone Tumour Around the Knee

Christine Eiser 1,✉, Paul Cool 2, Robert J Grimer 2, Simon R Carter 2, Imogen M Cotter 1, Ann J Ellis 1, Sheryl Kopel 1
PMCID: PMC2373584  PMID: 18521199

Abstract

Purpose. We report on the quality of life following treatment for a malignant primary bone tumour around the knee in skeletally immature children.

Patients. Patients (n = 41; mean age = 18 years; range 8–28) had all experienced chemotherapy in a neo-adjuvant setting, surgical excision of the tumour and endoprosthetic replacement.

Methods. Interviews were conducted separately with the child and mother and focused on mobility, body image and the impact of treatment on schooling, employment and plans for the future.

Results. Mobility in the group was variable. Only 12% reported that they could run with any confidence. The proportion who were able to swim (49%) or ride a bike (46%) was higher. All had experienced major disruption in schooling (mean absence following diagnosis = 12 months). Eight had repeated a school year and 41% patients reported that their schoolwork was affected. As a result of their experience, eight (six females and two males) chose health-related employment. Concerns for the future were highest among males and those with manual jobs. Three patients were receiving psychiatric support, in relation to extreme concern about the risk of recurrence. All expressed satisfaction with treatment, and older patients believed that the prosthesis gave a better quality of life than amputation.

Discussion. Our data suggest that outcome following limb-salvage surgery is variable. Education is disrupted. Even so, only two left school with no qualifications. Employment is most restricted among males with few qualifications who may benefit from sensitive vocational counselling.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Enneking W. F., Dunham W., Gebhardt M. C., Malawar M., Pritchard D. J. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res. 1993 Jan;(286):241–246. [PubMed] [Google Scholar]
  2. Finn H. A., Simon M. A. Limb-salvage surgery in the treatment of osteosarcoma in skeletally immature individuals. Clin Orthop Relat Res. 1991 Jan;(262):108–118. [PubMed] [Google Scholar]
  3. Gottsauner-Wolf F., Kotz R., Knahr K., Kristen H., Ritschl P., Salzer M. Rotationplasty for limb salvage in the treatment of malignant tumors at the knee. A follow-up study of seventy patients. J Bone Joint Surg Am. 1991 Oct;73(9):1365–1375. [PubMed] [Google Scholar]
  4. Jenkinson C., Coulter A., Wright L. Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. BMJ. 1993 May 29;306(6890):1437–1440. doi: 10.1136/bmj.306.6890.1437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Jenney M. E., Kane R. L., Lurie N. Developing a measure of health outcomes in survivors of childhood cancer: a review of the issues. Med Pediatr Oncol. 1995 Mar;24(3):145–153. doi: 10.1002/mpo.2950240302. [DOI] [PubMed] [Google Scholar]
  6. Kotz R., Salzer M. Rotation-plasty for childhood osteosarcoma of the distal part of the femur. J Bone Joint Surg Am. 1982 Sep;64(7):959–969. [PubMed] [Google Scholar]
  7. Mulhern R. K., Crisco J. J., Camitta B. M. Patterns of communication among pediatric patients with leukemia, parents, and physicians: prognostic disagreements and misunderstandings. J Pediatr. 1981 Sep;99(3):480–483. doi: 10.1016/s0022-3476(81)80355-1. [DOI] [PubMed] [Google Scholar]
  8. Robertson C. M., Hawkins M. M., Kingston J. E. Late deaths and survival after childhood cancer: implications for cure. BMJ. 1994 Jul 16;309(6948):162–166. doi: 10.1136/bmj.309.6948.162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Rougraff B. T., Simon M. A., Kneisl J. S., Greenberg D. B., Mankin H. J. Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. A long-term oncological, functional, and quality-of-life study. J Bone Joint Surg Am. 1994 May;76(5):649–656. doi: 10.2106/00004623-199405000-00004. [DOI] [PubMed] [Google Scholar]
  10. Simon M. A., Aschliman M. A., Thomas N., Mankin H. J. Limb-salvage treatment versus amputation for osteosarcoma of the distal end of the femur. J Bone Joint Surg Am. 1986 Dec;68(9):1331–1337. [PubMed] [Google Scholar]
  11. Spieth L. E., Harris C. V. Assessment of health-related quality of life in children and adolescents: an integrative review. J Pediatr Psychol. 1996 Apr;21(2):175–193. doi: 10.1093/jpepsy/21.2.175. [DOI] [PubMed] [Google Scholar]
  12. TUPMAN G. S. A study of bone growth in normal children and its relationship to skeletal maturation. J Bone Joint Surg Br. 1962 Feb;44-B:42–67. doi: 10.1302/0301-620X.44B1.42. [DOI] [PubMed] [Google Scholar]
  13. Weddington W. W., Jr, Segraves K. B., Simon M. A. Psychological outcome of extremity sarcoma survivors undergoing amputation or limb salvage. J Clin Oncol. 1985 Oct;3(10):1393–1399. doi: 10.1200/JCO.1985.3.10.1393. [DOI] [PubMed] [Google Scholar]

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