Nagarajan R, Clohisy D R, Neglia J P, Yasui Y, Mitby P A, Sklar C, Finklestein J Z, Greenberg M, Reaman G H, Zeltzer L, Robison L L
Division of Pediatrics, Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Mayo Mail Code 484, 420 Delaware St., SE Minneapolis, MN 55455, USA.
Br J Cancer. 2004 Nov 29;91(11):1858-65. doi: 10.1038/sj.bjc.6602220.
Limb-sparing surgeries have been performed more frequently than amputation based on the belief that limb-sparing surgeries provide improved function and quality-of-life (QOL). However, this has not been extensively studied in the paediatric population, which has unique characteristics that have implications for function and QOL. Using the Childhood Cancer Survivor Study, 528 adult long-term survivors of pediatric lower extremity bone tumours, diagnosed between 1970 and 1986, were contacted and completed questionnaries assessing function and QOL. Survivors were an average of 21 years from diagnosis with an average age of 35 years. Overall they reported excellent function and QOL. Compared to those who had a limb-sparing procedure, amputees were not more likely to have lower function and QOL scores and self-perception of disability included general health status, lower educational attainment, older age and female gender. Findings from this study suggest that, over time, amputees do as well as those who underwent limb-sparing surgeries between 1970 and 1986. However, female gender, lower educational attainment and older current age appear to influence function, QOL and disability.
保肢手术的实施频率高于截肢手术,这是基于人们认为保肢手术能改善功能和生活质量(QOL)的信念。然而,这在儿科人群中尚未得到广泛研究,儿科人群具有独特的特征,这些特征对功能和生活质量有影响。利用儿童癌症幸存者研究,联系了528名1970年至1986年间被诊断为小儿下肢骨肿瘤的成年长期幸存者,并完成了评估功能和生活质量的问卷。幸存者从诊断到现在平均21年,平均年龄35岁。总体而言,他们报告功能和生活质量良好。与接受保肢手术的人相比,截肢者功能和生活质量得分较低以及残疾自我认知的可能性并不更高,残疾自我认知包括总体健康状况、较低的教育程度、较高的年龄和女性性别。这项研究的结果表明,随着时间的推移,截肢者的情况与1970年至1986年间接受保肢手术的人一样好。然而,女性性别、较低的教育程度和当前较高的年龄似乎会影响功能、生活质量和残疾状况。