Psychosocial Functioning After Pediatric Bone Sarcoma: Generic and Survivor-Specific Outcomes in Adolescent and Young Adult Patients

BACKGROUND: Pediatric bone sarcoma patients and survivors may experience psychosocial challenges related to childhood cancer after their intensive, body-altering treatment. This cross-sectional study aimed to evaluate generic and survivor-specific psychosocial outcomes in a national cohort of pediatric bone sarcoma patients and survivors, and to explore associations between these outcomes.

METHODS: Patients treated for pediatric bone sarcoma, at least 2 years post-diagnosis, completed age-appropriate Pediatric Quality of Life Inventory (PedsQL) and PROMIS measures (generic outcomes). Patients ≥18 years additionally completed the impact of cancer-childhood survivor (IOC-CS) (survivor-specific outcomes). Generic psychosocial outcomes of patients were compared with age- and sex-specific Dutch normative data using one-sample t-tests. Linear regression analyses, adjusted for age and sex, examined associations between generic and survivor-specific outcomes.

RESULTS: In total, 139 patients participated (45% female). Mean age was 20.4 years (SD = 5.5) and mean time since end of treatment was 7.0 years (SD = 5.2). Patients scored significantly worse than normative values on cognitive functioning, pain interference, and health-related quality of life. In other generic domains, such as depressive symptoms or anxiety, patients scored comparably to or better than normative values. Survivor-specific outcomes were most positive in the socializing domain and most negative in the thinking and memory domain. Approximately 20% reported moderate-to-severe negative impact in at least one survivor-specific domain.

CONCLUSION: Overall, pediatric bone sarcoma patients demonstrated psychosocial outcomes comparable to or more favorable than normative values. However, specific domains showed worse outcomes. In addition, a substantial subgroup experienced moderate-to-severe negative impacts of childhood cancer. This highlights the importance of monitoring psychosocial functioning and, where indicated, targeted interventions to address challenges.