Factors influencing quality of life, function, reintegration and participation after musculoskeletal tumour operations

Wolfram Weschenfelder, Sabine Gast-Froehlich, Christian Spiegel, Matthias Vogt, Gunther O Hofmann, Wolfram Weschenfelder, Sabine Gast-Froehlich, Christian Spiegel, Matthias Vogt, Gunther O Hofmann

Abstract

Background: The number of people living with soft-tissue and bone sarcomas is increasing due to improved individual therapy and changes in demographics. At present, there are no recommendations for psychological co-treatment, occupational and social reintegration following the treatment of soft tissue and bone sarcomas.

Methods: Seventy-four patients, 42 males and 32 females, aged between 18 and 80 years (54.58 ± 16.99 yr.) with soft-tissue (62) and bone sarcomas (12) were included to answer five standardized and one personal questionnaire regarding quality of life, function, reintegration and participation after surgical treatment.

Results: A number of tumour-specific and patient-specific factors were identified that affected the therapeutic outcome. Patients with sarcoma of the lower extremity described poorer mobility. Patients who underwent amputation reported a higher anxious preoccupation. Patients with a higher range of education were less fatalistic and avoiding. The size of tumours or additive radiation therapy did not affect the post-therapeutic quality of life, coping and function. There was a good correlation between anxiety and depression with occupational reintegration, function, quality of life and coping.

Conclusion: Patients with sarcomas of the lower limb have a higher demand for postoperative rehabilitation and need more help in the postoperative occupational reintegration. Furthermore patients that underwent limb-preserving operations reported better postoperative function and quality of life. Risk assessment using patient-specific factors and an intensive psychological co-treatment may have a large role in the co-treatment of patients from the beginning of their cancer therapy.

Keywords: Ablative surgery; Amputation; Anxiety; Depression; Operation; Quality of life; Sarcoma.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Median values of SMFA in relation to tumour localization
Fig. 2
Fig. 2
Median of significant items of MAC in relation to school education and vocational training
Fig. 3
Fig. 3
Median of MAC in correlation to groups of HADS regarding anxiety and depression
Fig. 4
Fig. 4
Median of function items of SMFA in correlation to HADS groups regarding anxiety and depression

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