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

Pediatr Blood Cancer. 2009 Jul;53(1):84-9. doi: 10.1002/pbc.22027.

Abstract

Background: The purpose of this study was to evaluate late effects and symptom complaints in long-term survivors (>5 years) of Extremity Bone Sarcoma (EBS survivors). The results were compared with findings in age- and gender-matched individuals from the general population (NORMs).

Patients and methods: Among 155 EBS survivors approached, 133 (86%) were included, and 110 of them (83%) attended an outpatient examination. Health status was evaluated by a mailed questionnaire concerning demographic and current health issues, and physical examinations at the outpatient clinic. Age- and gender-adjusted normative controls were drawn from participants of the Health Study of Nord-Trøndelag County (HUNT 2).

Results: Median age at follow-up was 29 (15-57) years. Median follow-up was 12 (6-22) years. Of EBS survivors 42% had > or =1 somatic disease, 33% had ototoxicity and 13% had reduced renal function. EBS survivors were more likely to have heart disease (odds ratio [OR], 7.9; 95% confidence interval [95% CI], 2.5-25.3; P = 0.001), hypertension (OR, 3.4; 95% CI, 1.1-10.1; P = 0.03) and thyroid disease (OR, 3.0; 95% CI, 1.1-8.3; P = 0.04) compared to NORMs. EBS survivors reported more diarrhoea (29% vs. 19%, P = 0.02), palpitations (23% vs. 13%, P = 0.01) and shortness of breath (11% vs. 5%, P = 0.01) than NORMs.

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

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Neoplasms / blood
  • Bone Neoplasms / epidemiology*
  • Bone Neoplasms / therapy
  • Case-Control Studies
  • Chemotherapy, Adjuvant
  • Comorbidity
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology
  • Extremities
  • Female
  • Follow-Up Studies
  • Health Status
  • Heart Diseases / diagnosis
  • Heart Diseases / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Osteosarcoma / blood
  • Osteosarcoma / epidemiology*
  • Osteosarcoma / therapy
  • Postoperative Care / statistics & numerical data
  • Radiotherapy, Adjuvant
  • Sarcoma, Ewing / blood
  • Sarcoma, Ewing / epidemiology*
  • Sarcoma, Ewing / therapy
  • Survivors / statistics & numerical data*
  • Sweden / epidemiology
  • Thyroid Diseases / diagnosis
  • Thyroid Diseases / epidemiology
  • Young Adult