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Limb salvage surgery for non-metastatic sarcomas may improve patient-reported outcomes

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NEW ORLEANS —Patients with non-metastatic sarcomas who underwent limb salvage surgery had significantly improved physical function scores compared with patients who underwent amputation, according to data presented American Academy of Orthopaedic Surgeons Annual Meeting.

To determine whether surgical acuity or type of procedure affect the Patient Reported Outcomes Measurement Information System score, Benjamin Wilke, MD, and colleagues divided 138 patients with non-metastatic sarcomas based on whether they underwent limb salvage surgery or received an amputation. Researchers also subdivided patients based on whether they received follow-up either before or after 12 months of surgery.

Benjamin Wilke

“For the physical function domain, we did notice significant difference based on both the surgical acuity as well as the type of procedure performed,” Wilke said.

He said patients who received follow-up after 12 months postoperatively and patients who underwent limb salvage surgery had a significant increase in physical function. Patients who received follow-up after 12 months postoperatively also had a higher sense of ability to participate vs. patients who received follow-up before 12 months postoperatively.

“For this first question, the pain interference we also noted significant difference,” Wilke said. “This was not affected based on the type of surgical procedure performed, but it was affected based on the acuity, with the early patient cohorts having worse pain interference scores—so higher equals worse in this instance—and lower pain interference scores in the late cohort.”

When comparing these groups with the general U.S. population, Wilke noted several significant differences, including a significantly higher ability to participate among the limb salvage group.

“We also found less problems with sleep disturbance, fatigue and depression in the limb salvage group when compared to the U.S. general population, even though the physical function still remains significantly reduced,” Wilke said. – by Casey Tingle

Reference:

Wilke B, et al. Paper #114. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 6-10, 2018; New Orleans.

Disclosure: Wilke reports no relevant financial disclosures.