Background: The role of psychological distress and its impact on outcomes in extremity sarcoma patients (ES) has received little attention. Patients with ES face unique additional challenges compared to patients with other types of cancer. It is recognised that depression and anxiety during rehabilitation for other orthopaedic conditions has a negative impact on recovery and is associated with poor function and pain outcomes following joint arthroplasty. Psychosocial interventions have been shown to improve the effectiveness of rehabilitation after orthopaedic injuries.
Purpose: To further explore the current literature regarding psychological distress in extremity sarcoma.
Methods: Systematic review of the literature on extremity sarcoma in adults from five databases over the last ten years.
Results: Nine articles were selected. We divided studies into two groups. The first group made conclusions regarding the mental health of ES patients using either the mental health subscale of a global Quality of life (QoL) assessment tool or self-reported prevalence of depression and / or anxiety (six studies). The second group utilised tools designed to detect symptoms of psychological distress (three studies). Studies that used global QoL assessment tools concluded that mental health subscales were comparable between ES survivors and a normal reference population. However, studies that used tools to specifically detect distress reported a significant level of depression, anxiety, posttraumatic stress disorder as well as psychological distress.
Conclusion: The available literature regarding QoL in extremity sarcoma patients is heterogeneous in terms of aims and assessment tools. Psychological distress is an important but often overlooked aspect of care. There was a mismatch in findings between studies that used global QoL assessment tools and those that used tools to assess psychological distress symptoms. Further research is required to assess the role of psychological distress in influencing overall outcomes following surgery for extremity sarcoma.