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Psychosocial and functional outcomes in long‐term survivors of osteosarcoma: A comparison of limb‐salvage surgery and amputation
Author(s) -
Robert Rhonda S.,
Ottaviani Giulia,
Huh Winston W.,
Palla Shana,
Jaffe Norman
Publication year - 2010
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22419
Subject(s) - amputation , medicine , psychosocial , quality of life (healthcare) , osteosarcoma , surgery , activities of daily living , physical therapy , psychiatry , nursing , pathology
Background Traditionally, physicians have believed that limb‐salvage surgery has functional and cosmetic advantages over amputation, yet the literature is equivocal. Therefore, we sought to compare the psychosocial and functional outcomes in osteosarcoma survivors after limb‐salvage surgery and amputation. We hypothesized there to be neither psychosocial nor functional outcome differences between groups. Procedure Participants received treatment of extremity osteosarcoma, had received their cancer diagnosis at least 2 years prior, and were at least 16 years old. A comprehensive set of validated psychosocial and functional measures was used to assess outcome. Results Fifty‐seven patients participated in this study (33 who underwent limb‐salvage surgery and 24 who underwent amputation). Participants had gone 12–24 years since diagnosis and were 16–52 years old at study participation. We used multiple linear regression models to examine differences in quality of life, body image, self‐esteem, and social support between the two groups and found no differences. Lower limb function was a significant predictor of quality of life ( P < 0.001), whereas surgery type did not impact this relationship. Body image was rated significantly worse by those who underwent late amputation, amputation after failed limb salvage, than by those who did not. Conclusions Participants with more functional lower limbs had better quality of life than did those with less functional lower limbs regardless of whether they underwent amputation or limb‐salvage surgery. Pediatr Blood Cancer 2010;54:990–999 © 2010 Wiley‐Liss, Inc.