Health Status at Long-Term Follow-Up in Patients Treated for Extremity Localized Ewing Sarcoma or Osteosarcoma: A Scandinavian Sarcoma Group Study
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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-Trondelag 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 >= 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% Cl, 1.1-10.1; P=0.03) and thyroid disease (OR, 3.0; 95%, Cl, 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. Pediatr Blood Cancer 2009;53:84-89. (C) 2009 Wiley-Liss, Inc.