Article

OBJECTIVE: To evaluate health status and participation restrictions in survivors
of childhood extremity sarcomas. DESIGN: Members of the Childhood Cancer Survivor
Study cohort with extremity sarcomas who completed questionnaires in 1995, 2003,
or 2007 were included. SETTING: Cohort study of survivors of extremity sarcomas.
PARTICIPANTS: Childhood extremity sarcoma survivors (N=1094; median age at
diagnosis, 13y (range, 0-20y); current age, 33y (range, 10-53y); 49% male; 87.5%
white; 75% had lower extremity tumors) who received their diagnosis and treatment
between 1970 and 1986. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Prevalence rates for poor health status in 6 domains and 5 suboptimal social
participation categories were compared by tumor location and treatment exposure
with generalized estimating equations adjusted for demographic/personal factors
and time/age. RESULTS: In adjusted models, when compared with upper extremity
survivors, lower extremity survivors had an increased risk of activity
limitations but a lower risk of not completing college. Compared with those who
did not have surgery, those with limb-sparing (LS) and upper extremity
amputations (UEAs) were 1.6 times more likely to report functional impairment,
while those with an above-the-knee amputation (AKA) were 1.9 times more likely to
report functional impairment. Survivors treated with LS were 1.5 times more
likely to report activity limitations. Survivors undergoing LS were more likely
to report inactivity, incomes <$20,000, unemployment, and no college degree.
Those with UEAs more likely reported inactivity, unmarried status, and no college
degree. Those with AKA more likely reported no college degree. Treatment with
abdominal irradiation was associated with an increased risk of poor mental
health, functional impairment, and activity limitation. CONCLUSIONS: Treatment of
lower extremity sarcomas is associated with a 50% increased risk for activity
limitations; upper extremity survivors are at a 10% higher risk for not
completing college. The type of local control influences health status and
participation restrictions. Both of these outcomes decline with age.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS