Evaluation of quality of life in patients treated with resection and reconstruction of the upper or lower limb for bone sarcomas.

Abstract

10077 Background: Patients treated with limb salvage surgery for bone sarcomas of the extremities (upper and lower) may have physical disability as a result of treatment. Goal of this study was to evaluate the quality of life after treatment (chemotherapy and conservative surgery) at long term. Methods: 208 patients resected for a bone sarcoma and with prostetic reconstruction (45 in the upper and 163 in the lower limb) were evaluated. Assessments of results was done using the Karnofsky Scale (K.S.) (an attempt to measure the more “subjective” side of the outcome); this was obtained for each patient before and after treatment. Patients were followed in the clinic and functional results assessed according to the Musculoskeletal Tumor Society (MSTS) system. Moreover the Toronto Extremity Salvage Score questionnaire (TESS), a measure of physical disability, was mailed to 144 patients. Results: Before treatment 157 patients had a Karnofsky index between “50%” and “70%”, 96 patients between “0%” and “40%”. After treatment 94 patients had a Karnofsky index between “80%” and “100%”, 54 between “50%” and “70%”, and 34 below “40%”. Twentysix patients died with disease. For the upper limb MSTS system showed a mean value of 80%, with excellent or good results (MSTS score between 30 and 15) in 43 patients, fair or poor results (MSTS score between 14 and 0) in 2 patients. For the lower limb MSTS system showed a mean value of 76.6%, with excellent or good results in 145 patients (89%), fair or poor results in 18 patients (11%). Eighty-two patients sent back the TESS questionnaire. TESS was recorded an average of 3.7 years (upper limb) and 4.2 years (lower limb) after reconstruction. Mean TESS was similar in upper (75.3%) and lower (78.3%) limbs, but differed with age (patients older than 25 years did worse score). Conclusions: K.S. is a reliable for assessing quality of life of these patients. The 3 analyzed methods showed a good quality of life after treatment.The subjective view of K.S. and TESS is aligned with the MSTS results. No significant financial relationships to disclose.