Life In Adult Survivors Research Articles

Associations Between Aminoglycoside Antibiotic Treatment, Hearing Loss, Vestibular Function, Physical Activity, And Quality Of Life In Adult Survivors Of Childhood Cancer.

Associations Between Aminoglycoside Antibiotic Treatment, Hearing Loss, Vestibular Function, Physical Activity, And Quality Of Life In Adult Survivors Of Childhood Cancer.

Relationships between executive functioning and health-related quality of life in adult survivors of brain tumor and matched healthy controls

ABSTRACT Introduction Few studies have considered health-related quality of life (HRQOL) as a primary outcome measure in adult survivors of primary brain tumor (PBT), and fewer still have studied the cognitive factors that may influence it. Research suggests that executive functions (EFs) are associated with HRQOL, but there is scant evidence to support this. The present study was conducted to (1) extend prior findings about HRQOL limitations in a sample of stable, long-term adult survivors of PBT, (2) investigate the associations between objective/reported EFs and HRQOL, and (3) identify the EFs that contribute most to HRQOL. Method We recruited 40 survivors of PBT (> 2 years post-treatment) and 40 matched healthy controls. Participants completed an objective EF assessment (inhibition, working memory, shifting, and rule detection) and two self-report questionnaires probing EFs (Behavior Rating Inventory of Executive Function-Adult) and HRQOL (Medical Outcomes Study Short-Form 36). Participants’ relatives completed observer-rated versions of these questionnaires. Results Patients’ objective EF performances were relatively intact. However, patients and caregivers reported significantly more problems than healthy controls and their relatives, for both EFs and HRQOL. There were only negligible links between objective EFs and HRQOL, whereas numerous associations were found between reported EFs and HRQOL components. ANCOVA models revealed that specific reported EF processes contributed to both the physical and mental components of HRQOL, regardless of group. Conclusions From a clinical point of view, this study demonstrates that even several years after end of treatment, adult PBT survivors experience substantial problems across different HRQOL domains. HRQOL assessment should therefore be part of the long-term follow-up of PBT survivors, and clinicians should consider EF limitations when designing appropriate survivorship care plans. These findings indicate that cognitive interventions targeting EFs could improve HRQOL.

Work Status, Missed Time at Work, Work Performance, and Quality of Life in Adult Survivors of Hematopoietic Cell Transplant in Childhood

Background: Post-allogeneic hematopoietic cell transplant (HCT) work status is an important indicator of survivors' health recovery and social and economic well-being. However, current literature lacks data on work status, missed time at work, work performance, and quality of life (QOL) of long-term survivors of childhood HCT.Methods: A cross-sectional web-based survey study of ≥1-year survivors of childhood allogeneic HCT (performed between 1985-2010 at Children's Wisconsin, Milwaukee, WI) who were <18 years of age at HCT and ≥18 years of age at their most recent assessment. Eligible survivors were identified using the Center for International Blood and Marrow Transplant Research database and contacted by email and/or mail. Validated patient reported outcomes measures, the World Health Organization Health and Work Performance Questionnaire (HPQ) and the National Institutes of Health Patient Reported Outcomes Measurement Information System (PROMIS) were used to capture work and QOL data, respectively. Using HPQ responses, working survivors' work absenteeism and presenteeism scores were calculated. Absenteeism scores were also calculated for the survivors who reported to be students. Absolute absenteeism was defined as 4*(no. of hours expected at work or school) - no. of hours actually worked or attended school. Relative absenteeism was defined as absolute absenteeism score/ 4*(no. of hours expected at work or school). Absolute presenteeism was defined as 10*(self-reported work performance in last 4 weeks). Relative presenteeism was defined as self-reported work performance in last 4 weeks / self-reported performance of co-workers. Higher absenteeism and presenteeism scores indicated higher missed time at work or school and better work performance, respectively. PROMIS domains were scored on a T-score metric with a mean score of reference population at 50 and standard deviation of 10. The primary outcome was individual PROMIS domain score as a continuous variable. Univariate linear regression was performed to study factors associated with increase in PROMIS domain scores. For negatively worded domains (anxiety, depression, fatigue, sleep disturbance, cognitive concerns, pain interference), higher score was considered worse and for positively worded domains (physical function, satisfaction with social roles and activities), lower score was considered worse. Student survivors were considered employed in the analysis. P-value <0.05 was considered statistically significant.Results: Out of 99 allogeneic HCT recipients who met the selection criteria, 47 initiated the survey and 44 completed it (44% response rate). At the time of survey, 73% (n=32) of the respondents were working, 23% (n=10) were unemployed, and 4% (n=2) were students. Median age at HCT and survey were 11.1 years (interquartile range [IQR] 7.0-13.5) and 30.0 years (IQR 26.5-34.0), respectively. Median follow-up from HCT was 22 years (range 9-32). Fifty two percent were females and 75% received HCT for malignant diseases (acute lymphoblastic leukemia 45%). Compared to unemployed survivors, employed survivors reported less pain interference and sleep disturbance (Figure 1). History of acute graft vs. host disease (GVHD) was associated with worse physical function. Median absolute absenteeism and presenteeism scores were 0 hours (IQR [-1.5]-16) and 83 (IQR 73-92), respectively. Higher absolute presenteeism was associated with less pain interference and more satisfaction with social roles and activities and physical function. Higher relative presenteeism was associated with less cognitive concerns. Higher absolute absenteeism was associated with less depression and higher relative absenteeism with less fatigue (Table 1).Conclusions: Nearly a quarter of the survivors reported being unemployed at the time of the survey. Significant associations between survivors' work status, work performance, and QOL were identified. Our findings provide an important insight on the implications of work outcomes on HCT survivors' physical, mental, and social health and emphasizes the importance of routine longitudinal assessment of work status, performance and QOL in this population. These results also have the potential to help develop effective communication strategies with employers to balance work expectations of survivors in order to achieve better work productivity and in turn, good QOL. [Display omitted] DisclosuresBhatt: Johnson & Johnson: Divested equity in a private or publicly-traded company in the past 24 months; Moderna, Inc.: Divested equity in a private or publicly-traded company in the past 24 months; Pfizer Inc.: Divested equity in a private or publicly-traded company in the past 24 months; Rite Aid Corporation: Divested equity in a private or publicly-traded company in the past 24 months. Phelan: Amgen Pharmaceuticals: Research Funding. Shaw: mallinkrodt: Other: payments; Orca bio: Consultancy.

Associations between Cigarette Smoking and Health-Related Quality of Life in Adult Survivors of Adolescent and Young Adult Cancer.

This cross-sectional, secondary data analysis examines the association between cigarette smoking and self-reported health-related quality of life (HRQoL) in adult survivors of Adolescent and Young Adult Cancer. Pooled data for survivors of Adolescent and Young Adult Cancer (N = 1495) were drawn from the 2016 and 2017 Behavioral Risk Factor Surveillance Survey. Binary logistic regression models were utilized to examine independent associations between each of the four HRQoL domains (i.e., self-related general health, activity limitation days, poor physical, and mental health days) and cigarette smoking. Of the 1495 Adolescent and Young Adult Onset Cancer Survivors (AYAO-CS) in this study, approximately 30% reported currently smoking cigarettes. Relative to never smokers, the odds of reporting fair/poor general health were significantly higher for current and former smokers: (OR = 3.95, 95% CI: 2.08-7.50) and (OR = 2.51, 95% CI: 1.46-4.32), respectively. Likewise, current smokers were significantly more likely to report frequent days of poor physical health (OR = 2.79, 95% CI: 1.38-5.65). The study findings suggest a significant cross-sectional association between cigarette smoking and poor health-related quality of life in adult survivors of adolescent and young adult cancer. These findings, although cross-sectional, underscore the need for prospective studies to examine the longitudinal association between HRQoL and cigarette smoking among cancer survivors. Findings also help establish both the need for smoking cessation programs and the importance of effective strategies for addressing HRQoL issues among cancer survivors.

Quality of life in adult survivors after paediatric heart transplantation in Australia.

Paediatric heart transplantation in Australia is centralised at The Royal Children's Hospital, Melbourne. Survival to adulthood is improving but the ongoing need for complex medical therapy, surveillance, and potential for late complications continues to impact on quality of life. Quality of life in adults who underwent heart transplantation in childhood in Australia has not been assessed. Cross-sectional quality of life data were collected from paediatric heart transplant survivors >18 years of age using Rand 36-Item Health Survey. Self-reported raw scores were transformed to a 0-100 scale with higher scores indicating better quality of life. Mean scores were compared to National Health Survey Short Form-36 Population Norms data using the independent sample t-test. A total of 64 patients (64/151) who underwent transplantation at The Royal Children's Hospital between 1988 and 2016 survived to adulthood. In total 51 patients (51/64, 80%) were alive at the time of the study and 27 (53%) responded with a mean age of 25 ± 6 years, being a median of 11 years (interquartile range 7-19) post-transplantation. Most self-reported quality of life subscale scores were not significantly different from the Australian normative population data. However, self-reported 'General Health' was significantly worse than normative data (p = 0.02). Overall, 93% (25/27) reported their general health as being the same or better compared to 1-year ago. Adult survivors after paediatric heart transplantation in Australia report good quality of life in multiple domains and demonstrate independence in activities of daily living and employment. However, lifelong medical treatment may affect perceptions of general health.

Lifetime Achievement and Quality of Life in Adult Survivors of Pediatric Heart Transplant

Purpose As survival in pediatric heart transplant (HTx) improves, an increasing proportion of children receiving HTx are entering adulthood. Many quality of life (QOL) studies have looked at adult HTx patients, but only a few have looked at the population who received a HTx as a child. It is important to examine how this chronic illness affects children's development and eventual transition to adulthood, so that we may improve counseling of future patients. Methods Patients who received a HTx with the pediatric program at Columbia University Medical Center from 1984 through August 1, 2007, who are now > 18 years old and have survived over 10 years since HTx were asked to complete 2 surveys: (1) CHONY Pediatric Heart Transplant Life Achievement Survey, which examines marital and employment status, education level, personal income, health insurance status, and living environment, and (2) Quality of Life Index (QLI) by Ferrans and Powers, which scores life satisfaction from 0 (least satisfied) to 1 (most satisfied) as an overall score, and in 4 distinct domains (health/function, socioeconomic, psych/spiritual, and family). Results The Life Achievement Survey was completed by 54 patients (median age 8 years at transplant and 25 years at time of survey, 44% female, 26% transplanted for congenital heart disease). Fifteen patients have either been married (1 divorced) or part of an unmarried couple, and 7 have children (6 biological including 1 female). Thirty-seven patients are either employed or a student, and 16 earn over $25,000 annually. Almost a third of patients (n=16) live independently, while 5 are homeowners. Fifty patients completed the QLI and reported a mean overall QLI 0.76±0.14. The scores in the health/function, socioeconomic, psych/spiritual, and family domains were 0.77, 0.74, 0.74, and 0.8, respectively. Conclusion Our cohort of adult survivors of pediatric HTx have achieved many standard adult milestones such as receiving an education, maintaining relationships, being employed, and living independently. Additionally, they report a suitable QOL, especially in the health/function and family domains.

Lifestyle factors and health-related quality of life in adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort Study.

Survivors of childhood cancer report poor health-related quality of life (HRQOL). Modifiable lifestyle factors such as nutrition and physical activity represent opportunities for interventions to improve HRQOL. The authors examined the association between modifiable lifestyle factors and HRQOL among 2480 adult survivors of childhood cancer in the St. Jude Lifetime Cohort Study. Dietary intake, physical activity, cigarette smoking, and alcohol consumption were assessed through questionnaires. Weight and height were measured in the clinic. HRQOL was evaluated using the Medical Outcome Study 36-Item Short Form Survey. The physical component summary (PCS), mental component summary (MCS), and 8 domain scores of HRQOL were calculated. Multivariable linear regression models were used to estimate regression coefficients (β) associated with HRQOL differences. Being physically active (PCS β = 3.10; and MCS β = 1.48) was associated with higher HRQOL whereas current cigarette smoking (PCS β = -2.30; and MCS β = -6.49) and obesity (body mass index ≥30 kg/m2 ) (PCS β = -3.29; and MCS β = -1.61) were associated with lower HRQOL in both the physical and mental domains. Better diet (Healthy Eating Index-2015) was associated with higher physical HRQOL (PCS β = 1.79). Moderate alcohol consumption was associated with higher physical (PCS β = 1.14) but lower mental (MCS β = -1.13) HRQOL (all P <.05). Adherence to multiple healthy lifestyle factors demonstrated a linear trend with high scores in both physical and mental HRQOL (highest vs lowest adherence: PCS β = 7.60; and MCS β = 5.76 [P for trend, <.0001]). The association between healthy lifestyle factors and HRQOL is cumulative, underscoring the importance of promoting multiple healthy lifestyles to enhance HRQOL in long-term survivors of childhood cancer.

05 Long-term health-related quality of life in adult survivors of pediatric intracranial germ cell tumour

PURPOSE: To investigate health-related quality of life (HRQOL ) in survivors of intracranial germ cell tumors (IGCT). METHODS: Survivors of IGCT were invited to complete the 36-Item Short Form Survey Instrument (SF-36). The SF-36 is scored from 0-100, with a higher number representing a more favorable HRQOL. RESULTS: The study cohort consisted of 12 survivors of IGCT, 6 males and 6 females. Median age was 13 years at diagnosis, and 26 years at time of study. Median follow-up was 11 years. Five patients had germinomas, and 7 had non-germinomatous germ cell tumors. All 12 patients received radiation therapy (RT), 10 to the craniospinal axis, 1 to the whole ventricles and 1 to the tumor bed alone. Nine patients received chemotherapy. Mean SF-36 scores were 67.9 (standard deviation [SD] 33.2) for physical functioning, 58.3 (SD 37.4) for role limitations due to physical health, 77.8 (SD 32.8) for role limitations due to emotional problems, 43.1 (SD 18.4) for vitality, 74.3 (SD 15.3) for mental health; 62.5 (SD 32.0) for social functioning, 74.2 (SD 33.4) for pain, and 57.1 (SD 24.0) for general health; mean scores were &gt;1 SD lower than that of Canadian normative data for vitality, social functioning and general health. Physical component score was 43.6 (SD 13.9) and mental component score was 47.6 (SD 11.2), normalized to a US population with mean of 50 and SD of 10. CONCLUSIONS: Long-term HRQOL for survivors of IGCT is lower than that of the overall population, particularly in vitality, social functioning and general health.

Long-term quality of life in adult survivors after the arterial switch operation.

We sought to determine the quality of life after the arterial switch operation (ASO) using the Short Form 36 questionnaire in adult survivors. All patients (n = 107) who underwent the ASO and were 18 years of age or older living in the Australian state of Victoria with a contact telephone number were identified from the hospital database. Fifty-one (48%) patients were 18-24 years old and 56 (52%) patients were 25-34 years old. Patients completed the Short Form 36 quality of life questionnaire via telephone. The results of the 8 domains of the Short Form 36 questionnaire and the derived health state summary score (Short Form 6-Dimension) were compared against mean scores from age-matched Australian population data. Compared with the Australian population age-matched data, 18- to 24-year-old ASO patients ranked their health higher in 3 of the 8 domains (P < 0.01). The 25-34 age group ranked their health higher in 4 of the 8 domains (P < 0.01). No statistically significant differences in the mean Short Form 6-Dimension scores were observed in the 18-24 age group (0.769 for ASO patients vs 0.772 for Australian population, P = 0.85) or the 25-34 age group (0.795 for ASO patients vs 0.780 for Australian population, P = 0.33). Young adult survivors of the ASO have similar outcomes to age-matched controls in quality of life measured by Short Form 6-Dimension.

Vision-Targeted Health-Related Quality of Life in Adult Survivors of Retinoblastoma

ImportanceRetinoblastoma survivors are at risk for adverse oculo-visual outcomes. Limited data are available regarding long-term vision-targeted health-related quality of life (HRQoL) of adult retinoblastoma survivors.ObjectiveTo examine vision-targeted HRQoL as reported on the 25-item National Eye Institute Visual Field Questionnaire for overall and specific scale scores among adult survivors of retinoblastoma.Design, Setting, and ParticipantsThe Retinoblastoma Survivor Study is a retrospective cohort of adult retinoblastoma survivors treated at 3 academic medical centers in New York between 1932 and 1994. Participants completed a comprehensive questionnaire between April 2008 and June 2010. Items were scored in January 2013 and preliminary analyses were performed in July 2015. Models were finalized in May 2017.Main Outcomes and MeasuresSelf-reported vision-targeted HRQoL as reported on the 25-item National Eye Institute Visual Field Questionnaire. Items are scored from 0 to 100, with 100 representing the highest quality of life.ResultsAmong 470 adult retinoblastoma survivors (53.6% with bilateral disease; 52.1% female; 86.4% white and non-Hispanic; mean age at study, 43.3 years; range, 18.0-77.0 years), 86% had at least 1 eye removed (1 eye, 74.5%; both eyes, 11.5%); 56.5% were previously treated with radiotherapy; and 61.3% rated their eyesight as excellent/good while 16.2% reported complete blindness. The overall mean (SD) VFQ composite score for all survivors was 81.1 (17.2) (mean [SD] score for unilateral retinoblastoma survivors, 91.4 [7.7]; bilateral retinoblastoma survivors, 72.3 [18.2]; difference between survivors with unilateral and bilateral disease, 19.1 [95% CI, 16.5-21.7; P < .001]). Prior exposure to radiotherapy was not associated with decreased overall VFQ (β = −0.08; 95% CI, −0.15 to 0.002; P = .06) but was related to a few specific subdomains of visual functioning.Conclusions and RelevanceThese findings suggest retinoblastoma-related oculo-visual problems are associated with functional status and vision-targeted HRQoL of adult survivors, particularly among those with bilateral disease.

Quality of Life in Adult Survivors After Paediatric Heart Transplantation in Australia

Quality of Life in Adult Survivors After Paediatric Heart Transplantation in Australia

Peripheral Neuropathy, Function and Quality of Life in Adult Survivors of Childhood Acute Lymphoblastic Leukemia

To compare scores on measures of peripheral neuropathy, balance and quality of life (QoL) among adults survivors of childhood acute lymphoblastic leukemia (ALL) and age-, sex-, and race- matched community controls. To evaluate the association between neuropathy and balance, mobility, walking endurance and QoL among survivors.

“I Felt Like I Was Being Abused All Over Again”: How Survivors of Child Sexual Abuse Make Sense of the Perinatal Period Through Their Narratives

ABSTRACTSequelae following child sexual abuse pervade the lives of adult survivors, significantly impacting on pregnancy and childbirth. Symptoms of this distress are recognized, but meanings for women are less understood. This research aimed to examine the meaning for women themselves of the impact of child sexual abuse on experiences of pregnancy, childbirth, and the postnatal period. Taking a critical feminist perspective, three open-ended interviews with three survivors enabled women’s narratives of pregnancy and childbirth to be heard, explored the structure of these narratives, including how experiences were connected, and identified key themes and how selves and others were positioned. Women themselves contributed to the analysis of their own narratives. The different struggles of each woman occurred within three domains of experience: identity, embodiment, and parenting. They were underpinned by a fluctuation between empowerment and disempowerment. These findings, although based on detailed analysis of the experiences of only three women, dovetail with, integrate, and extend the existent literature, offering a framework for understanding the complexity of meaning making for women. Further research might develop this. The framework may facilitate clinicians’ understandings of what it is like for some women having children who have experienced child sexual abuse.

Frailty and quality of life in adult survivors of childhood cancer.

Adult survivors of childhood cancer are at risk for frailty, a state of diminished physiologic reserve, typically seen in older adults, associated with morbidity and mortality. They are also at risk for poor quality of life. This review explores potential associations between frailty and quality of life and proposes potential interventions that may prevent or remediate frail health. A literature search using MEDLINE and EMBASE was undertaken using key words: childhood cancer survivors and each of the following: frailty, physical performance, emotional health, and quality of life. 796 abstracts were reviewed for relevance. Reference lists for retrieved articles were consulted for pertinent manuscripts (N=40). Recent literature (from January 2013 to November 2016) was obtained using the key words: aging and frailty and quality of life. The final reference list includes 44 documents. Childhood cancer survivors are at risk for frailty and less than optimal quality of life. Poor emotional health may contribute to this association. Further research is needed to better explain these associations and to provide a foundation for the development of interventions designed to prevent and remediate frail health and suboptimal quality of life in this population.

Factors Influencing Health Related Quality of Life in Adult Survivors of Haematopoietic Stem Cell Transplantation

Factors Influencing Health Related Quality of Life in Adult Survivors of Haematopoietic Stem Cell Transplantation

Long-Term Quality of Life in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma.

Little is known about long-term quality of life (QoL) of survivors of pediatric differentiated thyroid carcinoma. Therefore, this study aimed to evaluate generic health-related QoL (HRQoL), fatigue, anxiety, and depression in these survivors compared with matched controls, and to evaluate thyroid cancer-specific HRQoL in survivors only. Survivors diagnosed between 1970 and 2013 at age ≤18 years, were included. Exclusion criteria were a follow-up <5 years, attained age <18 years, or diagnosis of DTC as a second malignant neoplasm (SMN). Controls were matched by age, sex, and socioeconomic status. Survivors and controls were asked to complete 3 questionnaires [Short-Form 36 (HRQoL), Multidimensional Fatigue Inventory 20 (fatigue), and Hospital Anxiety and Depression Scale (anxiety/depression)]. Survivors completed a thyroid cancer-specific HRQoL questionnaire. Sixty-seven survivors and 56 controls. Median age of survivors at evaluation was 34.2 years (range, 18.8 to 61.7). Median follow-up was 17.8 years (range, 5.0 to 44.7). On most QoL subscales, scores of survivors and controls did not differ significantly. However, survivors had more physical problems (P = 0.031), role limitations due to physical problems (P = 0.021), and mental fatigue (P = 0.016) than controls. Some thyroid cancer-specific complaints (e.g., sensory complaints and chilliness) were present in survivors. Unemployment and more extensive disease or treatment characteristics were most frequently associated with worse QoL. Overall, long-term QoL in survivors of pediatric DTC was normal. Survivors experienced mild impairment of QoL in some domains (physical problems, mental fatigue, and various thyroid cancer-specific complaints). Factors possibly affecting QoL need further exploration.

Adult CHD patients under clinical follow-up have a similar quality of life to the general population in Malta.

The improved survival of patients born with CHD has led to increasing interest in research on quality of life of adult survivors. We report the findings of the first study in Malta carried out to investigate quality of life in adults with CHD under follow-up. A self-reporting questionnaire modelled on the basis of the European Health Interview Survey 2008, including questions on mental health and vitality, was administered to consecutive adult CHD outpatients, aged 16 years and over, between May, 2013 and May, 2014. Foreigners and patients with learning difficulties or cognitive impairment were excluded. Quality-of-life data were compared with that from 371 age- and sex-matched 2008 survey responders - general population cohort. The impact of congenital lesion complexity, hospitalisation in the preceding 12 months, arrhythmias, co-morbidities, and cardiac medication use on quality of life of the CHD cohort was also investigated. There were a total of 120 patient responders (63 males; mean age 30.53, SD 12.77 years). Overall, there were no significant differences in mental health and vitality between patient and general population cohorts, although older patients had better mental health scores compared with age-matched controls. Within the adult CHD cohort, hospitalisation in the preceding 12 months was the only factor associated with a poorer quality of life. Overall, CHD has no negative impact on mental health and vitality in Maltese adult patients under follow-up. Patients needing frequent hospitalisations might warrant closer attention by clinical psychologists.

Long-term functional outcomes and quality of life in adult survivors of childhood extremity sarcomas: a report from the St. Jude Lifetime Cohort Study.

This study compared measured physical performance, health-related quality of life (HRQOL), and social role attainment between extremity sarcoma survivors and controls, and evaluated associations between disease and treatment exposures, health conditions, and performance measures. Survivors of extremity sarcoma from the St. Jude Lifetime cohort and controls frequency matched by age-, sex-, and race completed physical performance testing and questionnaires. Survivors with Z-scores on outcome measures ≤ -2.0 SD (compared to controls) were categorized with severe impairment/limitation. Among 206 survivors (52.4% male median age 36years (range 19-65)), 37% had low relative lean mass, 9.7% had an ejection fraction <50%, 51.5% had diffusion capacity for carbon monoxide <75%, 27.7% had sensory and 25.2% motor neuropathy, and 78.2% had musculoskeletal complications. Severe impairments/limitations were present among ≥25% of survivors on fitness, balance, and physical HRQOL measures, and among ≥15% on strength and activity of daily living measures. Lower extremity tumor location (OR 8.23, 95% CI 2.54-26.67, P value 0.0004) and amputation (OR 8.07, 95% CI 3.06-21.27, P value <0.0001) were associated with poor fitness. Poor fitness was associated with increased odds of scoring <40 on the SF-36 physical component summary (OR 4.83, 95% CI 1.95-11.99, P value 0.001) and role-physical subscale (OR 3.34, 95% CI 1.33-8.43, P value 0.01). Survivors and controls had similar rates of marriage, independent living, employment, and college attendance. Extremity sarcoma survivors experience high rates of physical impairment and report lower than expected physical HRQOL. However, they are as likely as peers to be married, live independently, be employed, and attend college. Follow-up for extremity sarcoma survivors should include assessment of need for further orthopedic care and rehabilitation to address cardiopulmonary and musculoskeletal health.

Protocol for a pilot randomised controlled trial of an online intervention for post-treatment cancer survivors with persistent fatigue

IntroductionMany post-treatment cancer survivors experience persistent fatigue that can disrupt attempts to resume normal everyday activities after treatment. Theoretical models that aim to explain contributory factors that initiate and sustain...

成人非ホジキンリンパ腫サバイバーにおける身体活動と生活の質との関連性

成人非ホジキンリンパ腫サバイバーにおける身体活動と生活の質との関連性