Functional outcome in sarcomas treated with limb-salvage surgery or amputation

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Oncology
• Reconstructive Surgery

Background:

• Functional outcome evaluation is crucial for surgical treatment of musculoskeletal tumors.
• The Enneking system is a standardized method for assessing functional outcomes after sarcoma surgery.

Purpose of the Study:

• To prospectively compare the functional outcomes of limb-salvage surgery versus amputation in patients with bone and soft tissue sarcomas.
• To evaluate the impact of different treatment modalities on functional results.

Main Methods:

• Prospective evaluation of 89 patients undergoing limb-salvage surgery and 58 patients undergoing amputation using the Enneking functional evaluation system.
• Patients with deep-seated extremity sarcomas, aged over 14, with >1 year follow-up were included.
• Statistical analysis included Wilcoxon and chi-squared tests.

Main Results:

• Limb-salvage surgery resulted in significantly higher functional scores (median 85) compared to amputation (median 47) (p<0.001).
• This difference was consistent across general health-related and extremity-related functional scores.
• No association was found between functional scores and tumor size, radiotherapy, tumor location, or surgical margin.

Conclusions:

• Limb-salvage surgery is associated with superior functional outcomes compared to amputation in patients with musculoskeletal sarcomas.
• Further studies are needed to determine if these functional differences translate to improved quality of life.