A Critical Review of the Impact of Sarcoma on Psychosocial Wellbeing

Table 2

Overview of study aims and methodology.

First author	Year	Country of origin	Study aims	Study design	Setting	Time focus	Quality score
Sugarbaker et al. [94]	1982	USA	To compare assessment of QOL between AMP versus LSS	Interventional^1	Single	During treatment	Q2/3^3
Weddington et al. [102]	1985	USA	To determine if LSS had better psychological outcomes than AMP in extremity sarcoma	Observational	Single	Follow-up	Q1
Postma et al. [80]	1992	Netherlands	To compare QOL in lower limb BT for LSS versus AMP	Observational	Single	Follow-up	Q2
Rougraff et al. [86]	1994	USA	To compare long-term outcomes for survivors of OS between LSS, AMP, and disarticulation at the hip	Observational	Multicentre	Long-term survivor	Q3
Sammallahti et al. [88]	1995	Finland	To describe the defences AYA OS survivors use	Observational	Single	Follow-up	Q2
Christ et al. [36]	1996	USA	To explore patterns of adjustment of long-term survivors of lower limb BT	Observational	Single	Long-term survivor	Q2
Felder-Puig et al. [46]	1998	Austria	To evaluate psychosocial adjustment, assess age-appropriate achievements, and identify problems in AYA with BT	Observational	Single	Follow-up	Q2/3
Davis et al. [41]	1999	Canada	To compare levels of disability between patients treated with LSS versus AMP	Observational	Single	Follow-up	Q2/3
Hillmann et al. [56]	1999	Germany	To evaluate the effect of rotationplasty, AMP, and LSS on QOL	Observational	Single	Follow-up	Q2/3
Davis et al. [40]	2000	Canada	To identify predictors of functional outcomes after LSS for STS	Observational	Single	Follow-up	Q2
Veenstra et al. [101]	2000	Netherlands	To assess the medium and long-term effects on QOL after rotationplasty	Observational	Multicentre	Follow-up	Q2
Eiser et al. [44]	2001	UK	To compare QOL to population norms and the differences between AMP versus LSS	Observational	Single	Follow-up	Q2/3
Malo et al. [64]	2001	Canada	To understand the impact of successful LSS for BT on patients' function	Observational	Multicentre	Follow-up	Q2/3
Rodl et al. [85]	2002	Germany	To evaluate QOL in patients at least 10 years after rotationplasty	Observational	Single	Long-term survivor	Q3
Servaes et al. [90]	2003	Netherlands	To investigate the prevalence and predictors of fatigue in patients with BT and STS	Longitudinal	Single	Follow-up	Q1
Marchese et al. [65]	2004	USA	To conduct a pilot study to examine the relationship between physical function and QOL in AYA survivors of OS	Pilot study	Single	Follow-up	Q2
Nagarajan et al. [69]	2004	USA	To assess function and QOL in long-term childhood survivors of lower limb BT	Observational	Multicentre	Long-term survivor	Q2
Zahlten-Hinguranage et al. [107]	2004	Germany	To determine the predictors of whether QOL is high for patients with AMP or LSS	Observational^2	Single	Follow-up	Q2
Koopman et al. [61]	2005	Netherlands	To investigate QOL and coping strategies in children at 3 and 8 years after the end of treatment	Longitudinal	Single	Follow-up	Q1
Tabone et al. [96]	2005	France	To assess the factors that impact on QOL in patients who had childhood BT	Observational	Multicentre	Follow-up	Q2
Gerber et al. [51]	2006	USA	To evaluate function and performance in adult survivors of child and adolescent sarcoma	Observational	Single	Follow-up	Q2
Hoffmann et al. [59]	2006	Germany	To determine the impact of surgery on QOL and function in long-term survivors after acetabulum resection	Observational	Single	Long-term survivor	Q2/3
Hopyan et al. [60]	2006	Australia	To determine whether children with AMP or rotationplasty were more physically active, functionally satisfied, and less psychosocial cost than those with LSS	Observational	Single	Long-term survivor	Q1
Marchese et al. [66]	2006	USA	Hypothesised that limited range of movement in children and adolescents who had LSS would have impaired functional mobility affecting QOL	Observational	Multicentre	Follow-up	Q3
Schreiber et al. [89]	2006	Canada	To evaluate how functional disability impacts on QOL of patients with extremity STS 1 year after surgery	Observational	Multicentre	Follow-up	Q2/3
Thijssens et al. [99]	2006	Netherlands	To investigate whether STS survivors had different QOL than a reference group and identify predictors of QOL and stress response	Observational	Single	Follow-up	Q2/3
Wiener et al. [104]	2006	USA	To determine the prevalence of psychological distress and posttraumatic stress symptoms in childhood sarcoma survivors	Observational	Single	Long-term survivor	Q1
Akahane et al. [28]	2007	Japan	To compare QOL for patients with OS around the knee between rotationplasty, LSS, and AMP	Observational	Multicentre	Follow-up	Q2/3
Aksnes et al. [29]	2007	Norway	To compare QOL, fatigue and mental distress in childhood survivors of BT to those with Hodgkin’s disease, testicular cancer, and normative data	Observational	Multicentre	Long-term survivor	Q1
Ginsberg et al. [52]	2007	USA	To compare QOL and functional outcomes of AYA survivors of lower limb BT after AMP, LSS, and rotationplasty	Observational	Multicentre	Follow-up	Q2/3
Beck et al. [32]	2008	USA	To compare functional outcomes and QOL following internal or external hemipelvectomy	Observational	Single	Follow-up	Q2/3
Davidge et al. [38]	2009	Canada	To examine the impact of preoperative outcome expectations with postoperative function and QOL	Observational	Single	Follow-up	Q2/3
Hinds et al. [57]	2009	USA	To evaluate the ability of adolescents at the time of diagnosis to self-report their QOL	Observational	Single	Diagnosis	Q1
Hinds et al. [58]	2009	USA	To assess the effect of treatment on children and adolescents QOL at the time of diagnosis, during and after treatment, and assess for differences in sex and age	Longitudinal	Multicentre	From diagnosis to follow-up	Q1
Nagarajan et al. [70]	2009	USA	To describe global function in childhood BT survivors, evaluate variables that may predict global function, and explore associations with QOL	Observational	Multicentre	Long-term survivor	Q2
Yonemoto et al. [106]	2009	Japan	To describe psychosocial outcomes of long-term child and adolescent survivors of OS	Observational	Single	Long-term survivor	Q2
Barrera et al. [30]	2010	Canada	To examine the impact of surgery and gender on sexual function in AYA survivors of lower limb BT	Observational	Single	Long-term survivor	Q1
Bekkering et al. [34]	2010	Netherlands	To compare QOL in children and AYA following surgery for BT around the knee joint of the leg with healthy controls	Observational	Multicentre	Follow-up	Q2
Robert et al. [84]	2010	USA	To compare psychosocial and functional outcomes of LSS and AMP in OS survivors	Observational	Single	Follow-up	Q2
Granda-Cameron et al. [54]	2011	USA	To examine symptom distress and QOL in newly diagnosed patients with sarcoma	Observational	Single	Diagnosis	Q2
Nagarajan et al. [71]	2011	USA	To evaluate survival, medical, and psychosocial outcomes and health status of survivors of childhood OS	Observational	Multicentre	Long-term survivor	Q2/3
Paredes et al. [74]	2011	Portugal	To examine change in QOL through diagnosis to treatment, and analyse predictors of QOL	Longitudinal	Single	Diagnosis and during treatment	Q1
Paredes et al. [73]	2011	Portugal	To understand how patients adjust to a sarcoma diagnosis at difference phases of the disease experience	Observational	Multicentre	Diagnosis, treatment, and follow-up	Q3
Expósito Tirado et al. [45]	2011	Spain	To compare QOL and physical function in young people with LSS versus AMP	Observational	Single	Long-term survivor	Q1
Barrera et al. [31]	2012	Canada	To investigate QOL in AYA survivors of lower limb BT as function of type of surgery, age, and gender	Observational	Single	Long-term survivor	Q1
Bekkering et al. [33]	2012	Netherlands	To evaluate QOL, functional ability, and physical activity during the first 2-years following surgery	Longitudinal	Multicentre	During treatment and follow-up	Q2
Forni et al. [49]	2012	Italy	To gain more knowledge on the QOL and experience of patients treated by rotationplasty and identify factors related to disability	Observational	Single	Follow-up	Q2
Han et al. [55]	2012	China	To investigate the QOL of patients with BT after surgery	Longitudinal	Single	During treatment and follow-up	Q1
Paredes et al. [76]	2012	Portugal	To determine if greater perceived social support is related to lower anxiety and depressions and better QOL, and explore differences at different phases of disease	Observational	Multicentre	Diagnosis, treatment, and follow-up	Q1
Paredes et al. [75]	2012	Portugal	To assess the emotional adjustment to diagnosis and treatment, and identify demographic and clinical variables predictive of adjustment	Longitudinal	Multicentre	Diagnosis and during treatment	Q1
Reichardt et al. [82]	2012	Canada, USA, Germany, France, Italy, Netherlands, Spain, UK, Sweden	To describe utility weights in metastatic sarcoma and explore QOL according to predefined health states	Observational	Multicentre	Metastatic disease	Q3
Smorti [92]	2012	Italy	To assess adolescents' expectations of the future after bone cancer treatment and to investigate the relationship between expectations of the future, resilience and coping strategies	Observational	Single	Follow-up	Q1
Sun et al. [95]	2012	China	To assess QOL after surgical treatment for BT and assess risk factors for improving physical and mental QOL	Longitudinal	Single	During treatment and follow-up	Q2/3
Teall et al. [98]	2012	Canada	To examine perceived social support and benefit finding with respect to surgical intervention, gender, and age; to compare these to normative values; and to examine the relationship between social and psychological outcomes and sexual functioning	Observational	Multicentre	Long-term survivor	Q1
Marina et al. [67]	2013	USA	To compare health status and participation restriction outcomes longitudinally for extremity sarcoma survivors to determine whether the trajectory over time varies as a function of tumour location	Longitudinal	Multicentre	Follow-up	Q3
Mason et al. [68]	2013	USA	To determine if there is a difference in QOL related to AMP or LSS	Observational	Single	Follow-up	Q2
Liu et al. [63]	2014	China	To explore the correlation between functional status and QOL in patients with lower limb BT	Observational	Multicentre	Follow-up	Q2/3
Ostacoli et al. [72]	2014	Italy	To compare QOL and anxiety and depression in the early stages of treatment compared to those with common types of cancer	Observational	Multicentre	During treatment	Q2/3
van Riel et al. [100]	2014	Netherlands	To assess self-perception and QOL of adolescents during or up to 3 months after adjuvant treatment for BT	Observational	Single	During treatment and follow-up	Q2
Chan et al. [35]	2015	Singapore	To describe QOL, symptom burden, and medication use in adult sarcoma patients	Observational	Single	During treatment	Q1
Custers et al. [37]	2015	Netherlands	To assess QOL, distress, and fear of cancer recurrence or progression in patients with GIST	Observational	Single	During treatment	Q1
Furtado et al. [50]	2015	UK	To describe physical function, QOL, and pain after AMP	Observational	Multicentre	Follow-up	Q2
Gradl et al. [53]	2015	Germany	To assess long-term QOL, functional performance, and psychosocial aspects after rotationplasty	Observational	Single	Long-term survivor	Q2
Rivard et al. [83]	2015	Canada	To document functional outcome and QOL in relation to wound complication rates	Observational	Single	During treatment and follow-up	Q2
Shchelkova and Usmanova [91]	2015	Russia	To investigate QOL and the relation to disease in patients with malignant BT	Observational	Single	ns	Q3
Stish et al. [93]	2015	USA	To assess patient-reported functional and QOL outcomes in survivors of ES	Observational	Single	Long-term survivor	Q1
Tang et al. [97]	2015	Australia	To identify the prevalence, trajectory, and determinants of distress and characterise sources of stress in patients with extremity sarcoma	Longitudinal	Single	Diagnosis and during treatment	Q2
Fidler et al. [48]	2015	UK	To investigate the long-term risks of adverse outcomes in 5-year survivors of childhood bone sarcoma	Observational	National	Long-term survivor	Q2/3
Davidson et al. [39]	2016	Canada	To estimate the change in QOL between diagnosis and 1-year after surgery	Longitudinal	Single	Diagnosis and during treatment	Q1
Dressler et al. [42]	2016	USA	To analyse of long-term QOL outcomes for patients with GIST	Observational	Single	Follow-up	Q1
Edelmann et al. [43]	2016	USA	To examine neurocognitive, neurobehavioural, emotional, and QOL outcomes in long-term survivors of childhood OS	Observational	Single	Long-term survivor	Q2
Leiser et al. [62]	2016	Switzerland, Germany	To evaluate clinical outcomes for children with RMS treated with pencil beam scanning, assess QOL, and identify prognostic factors for tumour control	Longitudinal	Multicentre	During treatment and follow-up	Q2
Phukan et al. [77]	2016	USA	To report QOL and functional outcomes after sacrectomy for malignant BT	Observational	Single	Follow-up	Q1
Poort et al. [79]	2016	Netherlands	To determine the prevalence of severe fatigue in patients with GIST, the impact on QOL, psychosocial and physical function, and the association with tyrosine kinase inhibitor use	Observational	Single	Follow-up	Q2
Weiner et al. [103]	2016	UK	To explore the extent of which child, adolescents, and their family engaged with psychological screening and whether they report concerns during the follow-up appointments	Feasibility	Single	ns	Q2/3
Bekkering et al. [108]	2017	Netherlands	To assess the course of QOL over time between 2 and 5 years or more after surgery	Longitudinal	Multicentre	Long-term survivor	Q2
Fernandez-Pineda et al. [47]	2017	USA	To compare QOL and social role attainment between extremity sarcoma and healthy control	Observational	Single	Long-term survivor	Q2
Podleska et al. [78]	2017	Germany	To gain insight into patients’ QOL after isolated limb perfusion and long-term survival	Observational	Single	Follow-up	Q2/3
Ranft et al. [81]	2017	Germany, Netherlands, Austria	To gather information on long-term outcome of ES, and look for prognostic factors for these outcomes	Observational	Multicentre	Follow-up	Q1
Saebye et al. [87]	2017	Denmark	To identify tumour- and patient-related factors associated with QOL after LSS for STS	Observational	Multicentre	Follow-up	Q2
Wong et al. [105]	2017	Canada	To examine how treatment-related toxicities affect QOL of patients with retroperitoneal sarcoma	Observational	Single	Follow-up	Q3

AMP: amputation; AYA: adolescents and young adults; BT: bone tumour; ES: Ewing sarcoma; GIST: gastrointestinal stromal tumour; LSS: limb-sparing surgery; ns: not stated; OS: osteosarcoma; QOL: quality of life; RMS: rhabdomyosarcoma; STS: soft tissue sarcoma. ¹Patient reported outcome measured as part of a clinical trial but reported independent to the trial results as it was an observational study. ²Described by the authors as a “qualitative study.” ³Quality rating includes 50% in both Q2 and Q3, so these were classified as both and rated as borderline poor.