High fatigue scores before and after surgical treatment of bone and soft tissue tumors

The first objective of the present study was to investigate fatigue severity in patients diagnosed with bone and soft tissue tumors prior to the surgical treatment of the tumor and 6 months post-operatively. The second objective was to determine which variables are associated with severe fatigue. Patients diagnosed with benign or low-grade malignant bone and soft tissue tumors, undergoing surgical therapy for the tumor only, were included in this study. The control group contained patients scheduled for knee arthroscopy for suspected meniscus tears. Fatigue, pain, anxiety and self-efficacy were measured pre-operatively and after 6 months and each patient wore an actometer to quantify physical activity. In the tumor group of 43 patients, 35% were severely fatigued pre-operatively and 33% post-operatively. The tumor group reported a significantly higher level of anxiety. No differences were observed in pain, physical limitations, self-efficacy or actometer scores. Multiple regression analysis of the tumor group revealed that higher pain scores, higher state anxiety and lower self-efficacy were asssociated with fatigue severity. In the control group of 24 knee arthroscopy patients, the percentage of severely fatigued patients decreased from 38% (n=9) prior to treatment to 29% (n=7) 6 months later. A substantial number of patients were severely fatigued in both the tumor group and the knee arthroscopy group. Self-efficacy, pain and anxiety appear to be the most important variables associated with fatigue severity in tumor patients prior to surgery.