Characteristics of Affected Limb Pain and Associated Factors in Young Adult Survivors of Lower Limb Osteosarcoma in Japan.
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PURPOSE: This study aimed to characterize affected-limb pain and its associated factors among adolescent and young adult (AYA) survivors of lower extremity osteosarcoma in Japan. We hypothesized that both physical and psychosocial factors would be associated with pain, with an interaction between pain intensity and pain interference. METHODS: A cross-sectional study was conducted among osteosarcoma survivors aged 18-39 years who had completed treatment at least 2 years earlier. Self-administered questionnaires assessed pain intensity and interference, physical function, fatigue, sleep disturbance, anxiety, depression, and perceived social support. Multiple regression analyses were performed to identify factors associated with pain outcomes. Semistructured interviews were also conducted to provide supplementary insights into pain characteristics and contextualize the quantitative findings. RESULTS: Among 64 participants, 65.6% reported pain or pain interference during the preceding 7 days. Pain intensity was significantly associated with poorer physical function, older age at diagnosis, and lower perceived social support, whereas pain interference was primarily associated with greater fatigue severity. Pain intensity and pain interference were strongly correlated. Qualitative analysis identified four pain characteristics prosthesis-related pain, phantom limb pain, secondary pain, and weather-related pain. Interviews further illustrated how physical limitations, fatigue, and social support shaped pain experiences. CONCLUSION: Pain among long-term osteosarcoma survivors is influenced by multiple biopsychosocial factors. Although average pain severity was relatively mild, substantial interindividual variability was observed. Comprehensive survivorship care should address physical function, fatigue management, and social support to optimize long-term pain management and self-care among AYA osteosarcoma survivors.