Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
BMC Cancer. 2020 Apr 25;20(1):351. doi: 10.1186/s12885-020-06837-x.
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.
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.
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.
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.
由于个体化治疗的改进和人口统计学的变化，软组织和骨肉瘤患者的数量正在增加。目前，对于软组织和骨肉瘤治疗后的心理共病治疗、职业和社会再融入，尚无相关推荐意见。
本研究共纳入 74 名患者，其中男性 42 名，女性 32 名，年龄 18-80 岁（54.58±16.99 岁），包括软组织肉瘤 62 例和骨肉瘤 12 例。他们回答了五个标准化问卷和一个个性化问卷，内容涉及手术后生活质量、功能、再融入和参与情况。
确定了一些与肿瘤特异性和患者特异性相关的因素，这些因素影响了治疗效果。下肢肉瘤患者的移动能力较差。接受截肢手术的患者表现出更高的焦虑。受教育程度较高的患者更少宿命论和回避。肿瘤的大小或附加放射治疗并不影响术后生活质量、应对和功能。焦虑和抑郁与职业再融入、功能、生活质量和应对能力之间存在良好的相关性。
下肢肉瘤患者对术后康复有更高的需求，在术后职业再融入方面需要更多的帮助。此外，接受保肢手术的患者术后功能和生活质量更好。使用患者特异性因素进行风险评估和强化心理共病治疗可能在癌症治疗开始时对患者的共病治疗发挥重要作用。
