Health-related quality of life in patients undergoing surgery for upper extremity bone tumors: A cross-sectional...

This study aims to evaluate health-related quality of life (HRQoL) in patients who underwent surgical treatment for upper extremity bone tumors, using validated patient-reported outcome measures, and to explore clinical factors associated with better or worse outcomes.

Between January 2015 and January 2024, a total of 55 patients (26 males, 29 females; mean age: 42.4 ± 19.0 years; range, 16 to 81 years) who were treated surgically for upper extremity bone tumors and evaluated at least six months postoperatively were included. The patients completed the EuroQol EQ-5D-5L and the Short Form-12 (SF-12) questionnaires. Clinical variables included age, sex, tumor site, pathology, treatment modality, and adjuvant or neoadjuvant therapies.

The humerus was the most frequent tumor site (60%), and joint involvement was present in 80% of cases. Benign tumors accounted for two-thirds of patients, while malignant tumors represented one-third. Curettage-based procedures predominated, and only two patients required amputation. Postoperative complications and recurrences were both observed in 7.3% of patients. On the EQ-5D-5L, 65.5% of patients reported no difficulty with mobility or self-care, but half experienced limitations in usual activities. Pain and discomfort were reported by 74.5%, and anxiety or depression by 67.3%. The mean EQ-5D-5L index was 0.55 ± 0.49 and the mean EQ-VAS was 70.9 ± 20.1. The mean SF-12 physical component score (PCS) and mental component score (MCS) were 42.6 ± 11.3 and 47.0 ± 11.2, respectively, indicating that physical functioning was more impaired than mental well-being. Correlation analyses demonstrated strong associations between EQ-5D-5L, EQ-VAS, and SF-12 scores, supporting convergent validity. Subgroup analyses revealed that younger patients (< 50 years), those with benign pathology, and individuals without adjuvant or neoadjuvant therapies reported significantly higher HRQoL scores.

Patients undergoing surgery for upper extremity bone tumors frequently experience pain and psychological distress despite preserved independence in mobility and self-care. Age, pathology, treatment intensity and tumor location were associated with HRQoL. These findings highlight the importance of rehabilitation and psychosocial support in postoperative care, alongside oncological and surgical management.