Treatment of extremital sarcoma patients may be associated with significant functional disabilities affecting quality of life (QoL) and therefore the return-to-work (RtW) process. Many studies report on RtW and QoL in childhood, adolescents and young adult cancer survivors of different malignancies. In contrast, studies looking at adult sarcoma patients in particular are limited.
Patients with the diagnosis of an extremital sarcoma of soft tissue and bone, surgically treated between 2000 and 2015, age at diagnosis of ≥ 18 or < 65 (age of retirement in Switzerland), alive and without evidence of sarcoma disease were invited for an interview. The primary objective was to investigate the employment rate. Secondary aims were to assess biomedical predictors of RtW and investigate the present QoL of adult sarcoma survivors. Health-related QoL measurements including physical, mental, and social domains were investigated with the following questionnaires: TESS (The Toronto Extremity Salvage Score), SF-36 (short-form health survey), CES-D (Center for Epidemiologic Studies-Depression Scale) and FoP-Q-SF (fear of progression).
5 out of 45 (11.1%) interviewed patients did not return to work. In the univariate analysis no statistically significant parameter predicting RtW could be detected. High educational level and full-time employment before sarcoma diagnosis showed a non-significant tendency towards predicting increased RtW probability. In the multivariate analysis full-time employment before sarcoma diagnosis is a significant predictor of RtW (OR 9.828 (1.318 – 73.303)) whereas high educational level does not show a significant influence. Neither the SF-36 physical and mental summary score nor the scores of the other interviews significantly correlated with RtW outcome. However, the mean difference in the FoP-Q-SF- score between the two groups (no RtW and RtW) was -10.981 (-18.242 to -3.720) in the multivariate model. Age at diagnosis, gender, type of sarcoma, tumor site/grade, amputation rate, Whoops procedure did not correlate with rate of RtW.
Our study reveals a high employment rate and good QoL of adult sarcoma survivors. Part-time employment and fear of progression might hamper the RtW process.
Clinical trial identification
Legal entity responsible for the study
Swiss Cancer League/Swiss Cancer Research.
All authors have declared no conflicts of interest.