Quality of life following amputation or limb salvage in patients with lower extremity sarcoma

Abstract

19530 Background: Currently between 80–90% of patients with lower extremity sarcoma undergo limb salvage procedures. A few trials show that the functional quality of life is significantly higher for limb salvage surgery compared to patients with amputation. While taking quality of life and psychological consequences into account it would seem that limb salvage would be the procedure of preference; however, this difference has yet to be demonstrated in previous studies. Methods: Eighty-two long-term survivors of lower extremity sarcoma were studied to make a comparison of the overall quality of life in limb salvage and amputation patients. Forty-eight patients with limb salvage (age 14–49 years) and thirty-four patients with amputations (age 15–49 years) were studied who were at least one-year post- surgical procedure. Sensitive psychometric measures such as self-report questionnaires and visual analog scales were used to assess psychological consequences and quality of life. Results: The overall quality of life of patients with the limb salvage was significantly higher than patients with amputation (p-value < 0.01). For the quality of life questionnaire, the limb salvage patients had a higher mean value in every domain except parent-child relations. The domains that showed a significant difference between patients with limb salvage and patients with amputations are material well being, occupational relations, creative-aesthetic behavior, and sports activity. Conclusions: For patients with lower extremity sarcoma, the psychological quality of life is better for those who received the limb salvage procedure. The significance of this study is that it one of the first to show that there is a direct benefit to limb salvage surgery as compared to amputation in regards to several psychological factors and total quality of life. No significant financial relationships to disclose.