Functional Outcome Measurement in Patients with Lower-Extremity Soft Tissue Sarcoma: A Systematic Literature Review

Abstract

BackgroundThe importance of functional outcome (FO) in the treatment of patients with extremity soft tissue sarcoma (STS) has been increasingly recognized in the last three decades. This systematic review aimed to investigate how FO is measured in surgically treated lower-extremity STS patients.MethodsA systematic search of PubMed, Web of Science, and Scopus was performed based on the PRISMA guidelines. The methodologic quality of the publications was measured using the MINORS tool. The results from the included studies examining measurement types, measures, and time of FO measurement were compiled. The FO pooled mean and standard deviation were calculated as a weighted average for the groups. The validity of the applied measures is reported.ResultsThe literature search found 3461 publications, 37 of which met the inclusion criteria. The measurement types used were clinician-reported outcomes (n = 27), patient-reported outcomes (n = 20), and observer-reported outcomes (n = 2). The most frequently used measures were the Toronto Extremity Salvage Score (TESS) (n = 16) and the Musculoskeletal Tumor Society (MSTS) score 1993 (n = 12). The postoperative FO was relatively good. The pooled mean TESS and MSTS 1993 scores were respectively 83.3 and 86.2 (out of 100). Of the 10 previously reported measures, 3 provide validated FO scores. The methodologic quality of publications was generally low.ConclusionsBased on this systematic review, several different methods exist for assessing FO in patients with lower-extremity sarcoma. The most frequently used measure is a validated TESS. The postoperative FO of patients with lower-extremity STS seems to increase to the preoperative baseline level during long-term follow-up evaluation.

Cross-Cultural Validation of the Italian Version of the Bt-DUX: A Subjective Measure of Health-Related Quality of Life in Patients Who Underwent Surgery for Lower Extremity Malignant Bone Tumour

“…The TESS score (median 89) was in line with that reported in the literature on comparable populations [ 26 , 27 , 28 ] with similar follow-ups.…”

Prospective Evaluation of Quality of Life and Functional Outcomes after Carbon Ion Radiotherapy for Inoperable Bone and Soft Tissue Sarcomas

“…A minimum follow-up period of 1 year was required for assessing QOL and functional outcomes. The observational period of >1 year was consistent with most previous studies [ 19 ]. The exclusion criteria were as follows: history of irradiation to the same site of primary disease and active double cancers.…”

“…The SF-8 questionnaires were administered by medical staff other than the physician to avoid interviewer bias. The MSTS scoring system is a physician-reported scale for assessing functional outcomes and is one of the most commonly used questionnaires in this field [ 19 ]. The MSTS score is based on six items: pain, overall function, and emotional acceptance, and three items specific to upper or lower body tumors.…”

Soft Tissue Sarcoma of Lower Extremity: Functional Outcome and Quality of Life

“…2 The aim of extremity STS treatment is patient survival and limb salvage with the best possible functional outcome. Several studies have been published on functional outcome after the treatment of patients with lower extremity STS, 3 but fewer on long-term health-related quality of life (HRQoL). [4][5][6][7] Few studies have focused on patient-related factors in analyzing long-term functional outcome and HRQoL in patients with postoperative lower extremity STS.…”