What Shapes Satisfaction With Daily Life Participation? Insights Into Functional Outcomes After Pediatric Bone...

Area of Science:

• Orthopedic Oncology
• Rehabilitation Medicine
• Pediatric Oncology

Background:

• Pediatric bone sarcoma treatment significantly impacts long-term functional outcomes.
• Understanding functional status and participation is vital for survivors' quality of life.

Purpose of the Study:

• To evaluate functional outcomes in pediatric bone sarcoma patients post-local therapy.
• To stratify outcomes by tumor location and surgical approach, particularly for knee-region tumors.
• To explore factors influencing patient satisfaction with participation.

Main Methods:

• A nationwide cohort of 122 pediatric bone sarcoma patients (≥2 years post-diagnosis) completed treatment for pelvic or lower extremity tumors.
• Functional outcomes assessed using PedsQL Fatigue, pain scales, mobility tests (10-MWT, 6-MWT), and PROMIS® measures.
• International Classification of Functioning, Disability and Health (ICF) framework guided assessments; participation satisfaction measured by USER-P.

Main Results:

• Patients reported worse outcomes in fatigue, mobility (10-MWT, 6-MWT), and physical functioning (PROMIS®-PF) compared to reference values.
• Pain interference scores were comparable to references, despite 57% reporting pain.
• No surgical approach was consistently superior for knee-region tumors; satisfaction was linked to restrictions and fatigue (p<0.001).

Conclusions:

• Functional outcomes in pediatric bone sarcoma survivors are diverse across ICF domains.
• Patient satisfaction with participation is associated with functional restrictions and fatigue.
• The surgical approach for knee-region bone sarcoma did not consistently predict outcomes, highlighting the importance of psychosocial factors and patient-centered care.