Health status at long‐term follow‐up in patients treated for extremity localized Ewing Sarcoma or osteosarcoma: A Scandinavian sarcoma group study

Aksnes, Liv Hege; Bauer, Henrik C. F.; Dahl, Alv A.; Fosså, Sophie D.; Hjorth, Lars; Jebsen, Nina L.; Lernedal, H.; Hall, Kirsten Sundby

doi:10.1002/pbc.22027

Cited by 26 publications

(18 citation statements)

References 51 publications

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“…Realistic and positive expectations lead to better health outcomes after surgical procedures [21], and so better data on what patients achieve in terms of sports performance after tumor surgery would be important. Furthermore, survivors of bone tumors pose a poorer health status compared with healthy control subjects [1] and physical training may provide beneficial effects on health like seen in cancer survivors in general [29,33]. In this study, we found moderate sports activity levels in patients after megaendoprosthetic reconstructions in the proximal femur, distal femur, and proximal tibia in the long term.…”

Section: Discussionmentioning

confidence: 48%

Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Hobusch

Lang

Schuh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Limb salvage surgery has evolved to become the standard method of treating sarcomas of the extremities with acceptable oncologic results. However, little information exists relative to the activity level or ability to participate in sports after tumor reconstructions. Questions/purposes The aims of the study were to answer the following questions: (1) Which sports activity levels and what types of sports can be expected in the long term after tumor reconstruction? (2) Which frequency durations are patients with Ewing's sarcoma able to perform in longterm followup after local control? (3) Do surgical complications affect sports activity level? Methods Thirty patients (13 females, 17 males; mean age, 18 ± 8 years; range, 2-36 years at diagnosis; mean followup 16 ± 6 years [minimum, 5 years]) were included. Tumors were located in the pelvis, femur, tibia, and fibula. Surgical procedures included surgical resections alone (n = 8), surgical resection with biological reconstruction (n = 9), or endoprosthetic reconstruction (n = 13). We assessed UCLA sports activity levels, kinds of sports as well as the frequency per week and the duration of each training unit at long term (minimum followup, 5 years). Results In long-term followup 83% patients (25 of 30) were performing athletic activity regularly. The hours/ week of sports depended on type of surgery and were highest after resections in the pelvis and femur (5.8) and were lowest after megaprosthetic reconstruction of the pelvis (1.0). Patients undergoing biologic reconstructions were able to perform high-impact sports. UCLA sports activity levels were high after joint-preserving vascularized fibula for tibia reconstruction (7.4) and after megaprosthetic reconstruction of the lower extremity (6.3-6.4) and were low after tumors located in the fibula (4.2). Complications during followup did not significantly influence sports activity in long-term survivors.

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Section: Discussionmentioning

confidence: 48%

Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Hobusch

Lang

Schuh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Examples are cardiac toxicity from anthracyclines, hearing loss or tinnitus from cisplatin, infertility from alkylator therapy or radiation to the pelvis, endocrine complications usually from radiation to reproductive organs or the hypothalamic-pituitary axis, bladder dysfunction from chemotherapy and radiation, and second malignant neoplasms due to radiation and/or chemotherapy. [88][89][90][91][92] Postpubertal boys should be offered semen cryopreservation before initiation of therapy. Cryopreservation of oocytes or embryos (the latter requires use of donor sperm) is possible for postpubertal females but may delay treatment initiation.…”

Section: Late Effectsmentioning

confidence: 99%

Common Musculoskeletal Tumors of Childhood and Adolescence

Arndt

Rose

Folpe

et al. 2012

Mayo Clinic Proceedings

256

174

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Osteosarcoma, Ewing sarcoma, and rhabdomyosarcoma are the most common malignant musculoskeletal tumors in children and adolescents. Today, most patients can be cured. Numerous factors have contributed to improved outcome for these patients over the past several decades. These include multidisciplinary care involving oncologists, radiation oncologists, surgeons, pathologists, and radiologists and enrollment of patients in clinical trials. Better understanding of molecular mechanisms of disease have resulted in studies using molecular targets in addition to standard chemotherapeutic agents, which hopefully will lead to better outcomes in the future. Moreover, new orthopedic techniques and devices as well as new technologies in radiation oncology hold promise for better local control of primary tumors and the potential for fewer late adverse effects. Despite this progress, patients must undergo lifelong follow-up for possible late effects of intense chemotherapy and radiation therapy. We review the diagnosis, prognosis, staging, multidisciplinary therapy, new directions in therapy, and long-term complications of treatment for these tumors. For this review, we searched MEDLINE using the terms rhabdomyosarcoma, osteosarcoma, Ewing sarcoma, biology, and humans and limited the search to articles from 2000 to September 2011. Additional references found in these articles were utilized as appropriate, as well as references from the background information in current therapeutic studies of the Children's Oncology Group. The same database and time frame were searched for articles written by leading authorities in the field.

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“…A systematic literature review concerning the body image of children and adolescents conducted by Fan and Eiser found that adolescents seem to have more body image concerns than younger children and that males cope better than females with appearance changes. Despite the numerous late effects of bone sarcoma treatment and the fact that many patients are left functionally impaired or disabled , body image is rarely studied in relation to this cancer.…”

Section: Introductionmentioning

confidence: 99%

Changes in the body image of bone sarcoma survivors following surgical treatment—A qualitative study

Fauske

Lorem

Grov

et al. 2015

Journal of Surgical Oncology

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Background and ObjectivesAmong several long‐term effects, people treated for cancer may experience an altered appearance. Our study aims to identify how visible body changes following surgical treatment affect the life and identity of primary bone sarcoma survivors 3–10 years after diagnosis. A qualitative, phenomenological, and hermeneutic design was applied.MethodsSarcoma survivors (n = 18) who were previously treated at Norwegian Radium Hospital, Oslo University Hospital, participated in the study. In‐depth and semi‐structured interviews were conducted and analyzed using inductive thematic analysis.ResultsThe main finding of this study concerned how altered appearance after bone cancer treatment in the hip/pelvis or lower extremities affected the participants’ self‐esteem. Half of the participants expressed concerns about their visible differences, particularly those with functional impairment. They felt that it is important to hide the bodily signs of changes to appear as normal as possible, as well as attractive and healthy. They describe, with specific examples, how these changes influence their self‐realization, especially their social life.ConclusionsHealthcare providers who guide bone sarcoma survivors during follow‐up should develop a comprehensive understanding of what it means to cope with a changed and challenging body. J. Surg. Oncol. 2016;113:229–234. © 2015 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.

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Health status at long‐term follow‐up in patients treated for extremity localized Ewing Sarcoma or osteosarcoma: A Scandinavian sarcoma group study

Abstract: EBS survivors have poorer health status compared to age- and gender-matched controls. Long-term follow-up of these patients is therefore mandatory.

Cited by 26 publications

References 51 publications

Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Common Musculoskeletal Tumors of Childhood and Adolescence

Changes in the body image of bone sarcoma survivors following surgical treatment—A qualitative study

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