Bekkering W P, van Egmond-van Dam J C, Bramer J A M, Beishuizen A, Fiocco M, Dijkstra P D S
Department of Orthopaedics, Rehabilitation and Physical Therapy, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands.
Department of Orthopaedic Surgery, Emma Children's Hospital, Academic Medical Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands.
Eur J Cancer Care (Engl). 2017 Jul;26(4). doi: 10.1111/ecc.12603. Epub 2016 Nov 7.
It remains unclear if quality of life (QoL) improvements could be expected in young patients after malignant bone tumour surgery after 2 years. To assess the course of QoL over time during a long-term follow-up, malignant bone tumour survivors of a previous short-term study were included. Assessments were done at least 5 years after surgery. QoL was measured with Short-form (SF)-36, TNO-AZL Questionnaire for Adult's Quality of Life (TAAQOL) and Bone tumour (Bt)-DUX. QoL throughout the follow-up was analysed by linear mixed model analysis. From the original cohort of 44 patients; 20 patients were included for this study, 10 males; mean age at surgery 15.1 years and mean follow-up 7.2 years. Twenty-one patients of the initial cohort (47%) deceased. Fifteen patients (75%) underwent limb-salvage and five (25%) ablative surgery. QoL improved significantly during follow-up at Physical Component Summary Scale scale of the SF-36 and TAAQOL and all subscales of the Bt-DUX (p < .01). No significant differences were found between current evaluations and previous evaluations at 2 years after surgery (p = .41-.98). Significant advantages after limb-salvage were seen at the PCS scale of the SF-36 (MD 13.7, p = .05) and the cosmetic scale of the Bt-DUX (MD 17.7, p = .04).
目前尚不清楚恶性骨肿瘤手术后2年的年轻患者是否有望改善生活质量（QoL）。为了评估长期随访期间QoL随时间的变化过程，纳入了先前一项短期研究中的恶性骨肿瘤幸存者。评估在手术后至少5年进行。使用简短健康调查量表（SF-36）、荷兰国家公共卫生与环境研究所成人生活质量问卷（TAAQOL）和骨肿瘤（Bt）-DUX来测量QoL。通过线性混合模型分析对整个随访期间的QoL进行分析。在最初的44例患者队列中，本研究纳入了20例患者，其中10例男性；手术时的平均年龄为15.1岁，平均随访时间为7.2年。最初队列中的21例患者（47%）死亡。15例患者（75%）接受了保肢手术，5例（25%）接受了截肢手术。在随访期间，SF-36和TAAQOL的身体成分汇总量表以及Bt-DUX的所有子量表的QoL均有显著改善（p < 0.01）。在手术后2年的当前评估与先前评估之间未发现显著差异（p = 0.41 - 0.98）。在SF-36的PCS量表（MD 13.7，p = 0.05）和Bt-DUX的美容量表（MD 17.7，p = 0.04）上，保肢术后有显著优势。
