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. 1999 Dec;3(3-4):183–190. doi: 10.1080/13577149977622

Quality of Life in Survivors of a Primary Bone Tumour: A Systematic Review

Christine Eiser 1,3,✉, Robert J Grimer 2
PMCID: PMC2395428  PMID: 18521283

Abstract

Purpose. We conducted a systematic search of published literature, to assess (i) quality of life (QoL) for survivors of a bone tumour compared with the normal population; (ii) QoL implications following amputation, successful or failed limb salvage; (iii) adaptation of young children to amputation compared with older children or adolescents.

Methods. Electronic databases were searched including Medline, PsycLIT and Cinahl covering the years 1982– 1998.

Results. We identified 11 studies. Regardless of treatment, physical functioning was poor compared with population norms or healthy siblings.There was less consistent evidence regarding emotional functioning. Seven studies compared functioning in amputees and limb salvage patients.Two reported advantages in physical function for the limb salvage group, one for the amputees and the rest no differences. Evidence about social functioning or marriage is inconclusive, but there are suggestions that amputees report more job discrimination.

Discussion. The literature is inconclusive, largely because of methodological problems. These include small and non-representative samples, and lack of sensitive and appropriate measures. Specific gaps in the literature include very little work concerned with psychological outcomes for children, or for those experiencing failed limb salvage. More attention needs to be given to gender differences in emotional response to traumatic surgery.The implications of the results for helping families balance the merits of different treatments are discussed.

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Selected References

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  1. Bergner M., Bobbitt R. A., Pollard W. E., Martin D. P., Gilson B. S. The sickness impact profile: validation of a health status measure. Med Care. 1976 Jan;14(1):57–67. doi: 10.1097/00005650-197601000-00006. [DOI] [PubMed] [Google Scholar]
  2. Bramwell V. H., Burgers M., Sneath R., Souhami R., van Oosterom A. T., Voûte P. A., Rouesse J., Spooner D., Craft A. W., Somers R. A comparison of two short intensive adjuvant chemotherapy regimens in operable osteosarcoma of limbs in children and young adults: the first study of the European Osteosarcoma Intergroup. J Clin Oncol. 1992 Oct;10(10):1579–1591. doi: 10.1200/JCO.1992.10.10.1579. [DOI] [PubMed] [Google Scholar]
  3. Derogatis L. R., Melisaratos N. The DSFI: a multidimensional measure of sexual functioning. J Sex Marital Ther. 1979 Fall;5(3):244–281. doi: 10.1080/00926237908403732. [DOI] [PubMed] [Google Scholar]
  4. Derogatis L. R. The psychosocial adjustment to illness scale (PAIS). J Psychosom Res. 1986;30(1):77–91. doi: 10.1016/0022-3999(86)90069-3. [DOI] [PubMed] [Google Scholar]
  5. Eiser C., Cool P., Grimer R. J., Carter S. R., Cotter I. M., Ellis A. J., Kopel S. Quality of life in children following treatment for a malignant primary bone tumour around the knee. Sarcoma. 1997;1(1):39–45. doi: 10.1080/13577149778461. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Endicott J., Spitzer R. L. A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry. 1978 Jul;35(7):837–844. doi: 10.1001/archpsyc.1978.01770310043002. [DOI] [PubMed] [Google Scholar]
  7. Feinstein A. R. Clinimetric perspectives. J Chronic Dis. 1987;40(6):635–640. doi: 10.1016/0021-9681(87)90027-0. [DOI] [PubMed] [Google Scholar]
  8. Felder-Puig R., Formann A. K., Mildner A., Bretschneider W., Bucher B., Windhager R., Zoubek A., Puig S., Topf R. Quality of life and psychosocial adjustment of young patients after treatment of bone cancer. Cancer. 1998 Jul 1;83(1):69–75. doi: 10.1002/(sici)1097-0142(19980701)83:1<69::aid-cncr10>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
  9. Greenberg D. B., Goorin A., Gebhardt M. C., Gupta L., Stier N., Harmon D., Mankin H. Quality of life in osteosarcoma survivors. Oncology (Williston Park) 1994 Nov;8(11):19-25; discussion 25-6, 32, 35. [PubMed] [Google Scholar]
  10. Grimer R. J., Carter S. R., Pynsent P. B. The cost-effectiveness of limb salvage for bone tumours. J Bone Joint Surg Br. 1997 Jul;79(4):558–561. doi: 10.1302/0301-620x.79b4.7687. [DOI] [PubMed] [Google Scholar]
  11. Hawkins M. M., Stevens M. C. The long-term survivors. Br Med Bull. 1996 Oct;52(4):898–923. doi: 10.1093/oxfordjournals.bmb.a011590. [DOI] [PubMed] [Google Scholar]
  12. Horowitz M., Wilner N., Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979 May;41(3):209–218. doi: 10.1097/00006842-197905000-00004. [DOI] [PubMed] [Google Scholar]
  13. Insall J. N., Dorr L. D., Scott R. D., Scott W. N. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989 Nov;(248):13–14. [PubMed] [Google Scholar]
  14. Jacobs J. W., Bernhard M. R., Delgado A., Strain J. J. Screening for organic mental syndromes in the medically ill. Ann Intern Med. 1977 Jan;86(1):40–46. doi: 10.7326/0003-4819-86-1-40. [DOI] [PubMed] [Google Scholar]
  15. 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]
  16. Johansen R., Nielsen O. S., Keller J. Functional outcome in sarcomas treated with limb-salvage surgery or amputation. Sarcoma. 1998;2(1):19–23. doi: 10.1080/13577149878118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Katz S., Akpom C. A. A measure of primary sociobiological functions. Int J Health Serv. 1976;6(3):493–508. doi: 10.2190/UURL-2RYU-WRYD-EY3K. [DOI] [PubMed] [Google Scholar]
  18. Kempen G. I., Suurmeijer T. P. The development of a hierarchical polychotomous ADL-IADL scale for noninstitutionalized elders. Gerontologist. 1990 Aug;30(4):497–502. doi: 10.1093/geront/30.4.497. [DOI] [PubMed] [Google Scholar]
  19. Leplège A., Hunt S. The problem of quality of life in medicine. JAMA. 1997 Jul 2;278(1):47–50. doi: 10.1001/jama.1997.03550010061041. [DOI] [PubMed] [Google Scholar]
  20. Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain. 1975 Sep;1(3):277–299. doi: 10.1016/0304-3959(75)90044-5. [DOI] [PubMed] [Google Scholar]
  21. Nicholson H. S., Mulvihill J. J., Byrne J. Late effects of therapy in adult survivors of osteosarcoma and Ewing's sarcoma. Med Pediatr Oncol. 1992;20(1):6–12. doi: 10.1002/mpo.2950200103. [DOI] [PubMed] [Google Scholar]
  22. Novakovic B., Fears T. R., Horowitz M. E., Tucker M. A., Wexler L. H. Late effects of therapy in survivors of Ewing's sarcoma family tumors. J Pediatr Hematol Oncol. 1997 May-Jun;19(3):220–225. doi: 10.1097/00043426-199705000-00008. [DOI] [PubMed] [Google Scholar]
  23. Postma A., Kingma A., De Ruiter J. H., Schraffordt Koops H., Veth R. P., Goëken L. N., Kamps W. A. Quality of life in bone tumor patients comparing limb salvage and amputation of the lower extremity. J Surg Oncol. 1992 Sep;51(1):47–51. doi: 10.1002/jso.2930510113. [DOI] [PubMed] [Google Scholar]
  24. Reaman G. H., Haase G. M. Quality of life research in childhood cancer. The time is now. Cancer. 1996 Sep 15;78(6):1330–1332. doi: 10.1002/(SICI)1097-0142(19960915)78:6<1330::AID-CNCR23>3.0.CO;2-0. [DOI] [PubMed] [Google Scholar]
  25. 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]
  26. Sugarbaker P. H., Barofsky I., Rosenberg S. A., Gianola F. J. Quality of life assessment of patients in extremity sarcoma clinical trials. Surgery. 1982 Jan;91(1):17–23. [PubMed] [Google Scholar]
  27. 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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