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Understanding Physical Functioning in Patients with Sarcoma After Amputation: Using an International Classification

Tom I Bootsma1,2, Dide den Hollander3,4, Milou J P Reuvers3,5

  • 1Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands. t.bootsma@erasmusmc.nl.

Annals of Surgical Oncology
|April 5, 2026
PubMed
Summary
This summary is machine-generated.

Physical functioning (PF) measurement after sarcoma amputation requires a tailored strategy. Current tools like the EORTC QLQ-C30 and TESS do not fully capture patient experiences or contextual factors impacting recovery.

Keywords:
AmputationEORTC QLQ-C30Extremity sarcomaHealth-related quality of lifePRO developmentPatient-reported outcomesPhysical functioningTESS

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Area of Science:

  • Oncology
  • Rehabilitation Medicine
  • Health Outcomes Research

Background:

  • Physical functioning (PF) is significantly impacted by amputation in extremity/pelvic sarcoma patients.
  • Existing health-related quality of life (HRQoL) measures, including the EORTC QLQ-C30 and TESS, lack validation in this specific patient cohort.
  • Understanding patient interpretation of PF measures, especially concerning assistive devices, is crucial.

Purpose of the Study:

  • To examine the challenges in measuring PF for sarcoma patients post-amputation.
  • To explore patient interpretations of the TESS and EORTC QLQ-C30 regarding their physical functioning.
  • To consider PF within the International Classification of Functioning, Disability and Health (ICF) framework.

Main Methods:

  • Semistructured interviews were conducted with 20 patients who underwent amputation for extremity/pelvic sarcoma.
  • Interviews focused on patients' experiences of PF as assessed by the C30 and TESS.
  • Thematic analysis was performed, organizing data into key themes and subthemes aligned with the ICF framework.

Main Results:

  • Amputation affects five interrelated ICF domains: body functions/structures, activity/participation, and environmental factors.
  • Patients reported challenges in sensory functions, pain, movement, and reproductive health.
  • Limitations were observed in general tasks, mobility, self-care, domestic life, and social/civic participation, influenced by environmental factors like technology and social support.

Conclusions:

  • A specialized measurement strategy is essential for sarcoma patients following amputation.
  • The EORTC QLQ-C30 and TESS do not adequately incorporate contextual factors.
  • This omission can lead to inaccurate PF scoring in this population.