Evidence map›Paper›PMID 42384352›Full record

ArticleJournal of cancer survivorship : research and practice2026

Fatigue after pediatric bone sarcoma: prevalence and associated factors in pediatric and adult patients and survivors after treatment.

Hinke van der Hoek, Heleen Maurice-Stam, Laura R Beek, Jennifer van Dijk, Marjolein E M Langemeijer, Relinde W Slooff-Lentink, Alied M van der Aa-van Delden, Hendrik W B Schreuder, Lianne M Haveman, Willem P Bekkering and 4 more

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Article in Journal of cancer survivorship : research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Hinke van der HoekPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0002-0020-5036
Heleen Maurice-StamPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Laura R BeekPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Jennifer van DijkPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Marjolein E M LangemeijerPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Relinde W Slooff-LentinkPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Alied M van der Aa-van DeldenPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Hendrik W B SchreuderPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Lianne M HavemanPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0001-8519-8906
Willem P BekkeringPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0009-0001-2789-2710
Leonie G TigelaarPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0009-0002-1276-7009
Johannes H M MerksPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0001-7659-1028
Martha A GrootenhuisPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID http://orcid.org/0000-0002-9632-248X
Raphaële R L van LitsenburgPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands. r.r.l.vanlitsenburg@prinsesmaximacentrum.nl.ORCID http://orcid.org/0000-0003-1779-6159

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFatigue is a common long-term complaint in childhood cancer patients and survivors. Treatment of pediatric bone sarcomas is intensive and can lead to physical, functional and psychosocial challenges; however, little is known about fatigue in this group. This study aimed to gain insight into fatigue and related demographic, medical, psychosocial, and lifestyle factors in pediatric bone sarcoma patients and survivors.

methodsPatients treated for pediatric bone sarcoma, ≥ 2 years post-diagnosis and after completion of treatment with no evidence of disease, completed PedsQL™ Multidimensional Fatigue Scale and PROMIS® fatigue measures. Prevalence and mean scores were compared with Dutch normative data using binomial tests, one-sample t-tests, and ANOVA. Linear regression analyses examined associations of fatigue with demographic and medical factors, psychological difficulties (measured with emotion thermometers), pain (measured with a numeric rating scale), and physical activity (using an accelerometer).

resultsIn total, 139 patients participated. In children (N = 44), 51.6% (95% CI 34.0-69.2) reported moderate to severe fatigue, significantly higher than the weighted norm (29.8%), while adults (N = 95) (11.5%, 95% CI 4.4-18.6) did not differ from the weighted norm (12.1%). Children scored worse than the norm on all fatigue measures (Cohen's d range = 0.58 to 1.10); adults did not significantly differ. Longer time since end of treatment was associated with less cognitive fatigue. More psychological difficulties and pain were associated with more fatigue, while higher levels of physical activity were associated with less fatigue.

conclusionChildren after pediatric bone sarcoma experience more fatigue than the norm. More psychological difficulties, more pain, and less physical activity are associated with more fatigue. Medical factors are limited to time since end of treatment, where a longer time is associated with less cognitive fatigue. IMPLICATIONS FOR CANCER SURVIVORS: Screening for fatigue and associated factors during treatment and follow-up may help identify and support patients at risk.

Indexed as

Bone neoplasmsCancerFatigueOncologyPsycho-oncologyPsychosocial functioningQuality of lifeSupportive careSurvivors

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.