Department of Orthopedics and Trauma Surgery, Comprehensive Cancer Canter Vienna, Medical University of Vienna, Waehringer Straße 18-20, 1090, Vienna, Austria.
Center for Medical Statistics, Informatics and Intelligent Systems (CeMSIIS), Medical University of Vienna, Vienna, Austria.
Support Care Cancer. 2023 Mar 1;31(3):193. doi: 10.1007/s00520-023-07644-3.
Little is known about the effect of sports activity levels on health-related quality of life (HRQOL) in long-term survivors of lower-extremity sarcoma.
Eighty-three long-term survivors of bone and soft tissue sarcoma of the lower extremities with a median follow-up of 14 (range: 5-35) years completed the University of California and Los Angeles (UCLA) activity scores before tumor resection, 1 year after surgery and at the latest follow-up, as well as a Short Form 36 (SF-36) health survey at the latest follow-up. Simple linear regression models as well as stepwise variable selection with Akaike information criterion (AIC) were undertaken.
The preoperative UCLA activity level (median: 9, range: 2-10) dropped to a median of 4 (range: 1-10) 1 year after surgery before increasing to a score of 6 (range: 2-10) 5 years after surgery. The long-term SF-36 physical health component summary score (PCS) was 49 (SD: 9), and the mental health component summary score (MCS) was 54 (SD: 7). A linear model with stepwise variable selection identified a negative correlation of PCS with age at surgery (estimate: -0.2; p = 0.02), UCLA score at the last follow-up (estimate: 1.4; p = 0.02) and UCLA score 1 year after surgery (estimate: 1.0; p = 0.02).
As not only the final activity levels but also the status immediately after surgery affect the PCS, higher early activity levels should be a goal of modern rehabilitation after sarcoma treatment. Further studies are needed to weigh the potential postoperative risks of higher sport activity levels against the benefits described in this study.
Level 4.
对于下肢肉瘤的长期幸存者，运动活动水平对健康相关生活质量（HRQOL）的影响知之甚少。
83 例下肢骨和软组织肉瘤的长期幸存者，中位随访时间为 14 年（范围：5-35 年），在肿瘤切除前、手术后 1 年和最近随访时完成了加利福尼亚大学洛杉矶分校（UCLA）活动评分，以及在最近随访时完成了健康调查的 36 项简短健康调查问卷（SF-36）。采用简单线性回归模型和基于赤池信息量准则（AIC）的逐步变量选择。
术前 UCLA 活动水平（中位数：9，范围：2-10）在手术后 1 年内降至中位数 4（范围：1-10），然后在手术后 5 年内增加到 6（范围：2-10）。长期 SF-36 身体健康成分综合评分（PCS）为 49（SD：9），心理健康成分综合评分（MCS）为 54（SD：7）。采用逐步变量选择的线性模型确定 PCS 与手术时年龄（估计值：-0.2；p=0.02）、最后一次随访时的 UCLA 评分（估计值：1.4；p=0.02）和手术后 1 年的 UCLA 评分（估计值：1.0；p=0.02）呈负相关。
由于不仅最终的活动水平，而且手术后的状态也会影响 PCS，因此现代肉瘤治疗后的康复应将更高的早期活动水平作为目标。需要进一步的研究来权衡更高运动活动水平的潜在术后风险与本研究中描述的益处。
4 级。
