Functional outcomes and quality of life in patients with osteosarcoma treated with amputation versus limb-salvage surgery: a systematic review and meta-analysis

Mei, Jiong; Zhu, Xiaoyan; Wang, Zhiyuan; Cai, Xuan-Song

doi:10.1007/s00402-014-2086-5

Cited by 57 publications

(48 citation statements)

References 28 publications

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“…Complete surgical resection, if feasible, remains essential for cure [22]. Current surgical strategies focus on refining the nature and scope of resection to preserve uninvolved tissues.…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of randomized control trials of surgical methods with osteosarcoma outcomes

Gao

et al. 2017

J Orthop Surg Res

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BackgroundOsteosarcoma is a high malignant neoplasm, and conflicting findings have been reported on the survival and function recovery of osteosarcoma patients experiencing limb salvage or amputation. In the present study, we compared limb salvage surgery (LSS) with amputation in clinical outcomes of osteosarcoma patients by a meta-analysis.MethodsThe survival rate of osteosarcoma patients was collected from research reports from CNKI, MEDLINE, EMBASE, the Cochrane Database, and Google Scholar till April 30, 2016. The quality of including articles was evaluated by two independent reviewers. Differences between patients undergoing limb salvage surgery and amputation were analyzed based on postoperative survival rates.ResultsTen articles were included according to selection criteria. There were 1343 patients in total from these studies. Our results showed that there was no significant difference between limb salvage surgery and amputation according to local recurrence; however, patients with limb salvage surgery had a higher 5-year overall survival.ConclusionsLSS results in higher 5-year survival rates and better survival, while not increasing the risk of local recurrence. This study provided more evidences to support limb salvage surgery as a considerable treatment of osteosarcoma patients.

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“…Complete surgical resection, if feasible, remains essential for cure [22]. Current surgical strategies focus on refining the nature and scope of resection to preserve uninvolved tissues.…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of randomized control trials of surgical methods with osteosarcoma outcomes

Gao

et al. 2017

J Orthop Surg Res

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“…Extirpation of tumor tissue is expected to cause some degree of functional impairment; therefore, efforts should be made to decrease such impairment. Studies have reported on the functional outcomes of impairments on musculoskeletal tumor treatment [9,10,14,16,17,19,21].…”

Section: Introductionmentioning

confidence: 99%

“…Since then, this system has been used in numerous studies to evaluate functional outcomes [9,10,14,16,17,19,22], making it one of the most widely used functional evaluation tools. The original scoring system was written in English and subsequently has been translated into Brazilian Portuguese and Japanese.…”

Section: Introductionmentioning

confidence: 99%

Reliability and Validity of a Japanese-language and Culturally Adapted Version of the Musculoskeletal Tumor Society Scoring System for the Lower Extremity

Iwata

Uehara

Akiyama

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background The Musculoskeletal Tumor Society (MSTS) scoring system is a widely used functional evaluation tool for patients treated for musculoskeletal tumors. Although the MSTS scoring system has been validated in English and Brazilian Portuguese, a Japanese version of the MSTS scoring system has not yet been validated. Questions/purpose We sought to determine whether a Japanese-language translation of the MSTS scoring system for the lower extremity had (1) sufficient reliability and internal consistency, (2) adequate construct validity, and (3) reasonable criterion validity compared with the Toronto Extremity Salvage Score (TESS) and SF-36 using psychometric analysis. Methods The Japanese version of the MSTS scoring system was developed using accepted guidelines, which included translation of the English version of the MSTS into Japanese by five native Japanese bilingual musculoskeletal oncology surgeons and integrated into one document. One hundred patients with a diagnosis of intermediate or malignant bone or soft tissue tumors located in the lower extremity and who had undergone tumor resection with or without reconstruction or amputation participated in this study. Reliability was evaluated by test-retest analysis, and internal consistency was established by Cronbach's alpha coefficient. Construct validity was evaluated using the principal factor analysis and Akaike information criterion network. Criterion validity was evaluated by comparing the MSTS scoring system with the TESS and SF-36. Results Test-retest analysis showed a high intraclass correlation coefficient (0.92; 95% CI, 0.88-0.95), indicating high reliability of the Japanese version of the MSTS The institution of one or more of the authors (SI, KO, TY, AK) has received, during the study period, funding from the National Cancer Center Research and Development Fund (Grant 26-A-4). Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that may pose a conflict of interest with respect to the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, and all investigations were conducted in conformity with the ethical principles of research. This work was performed at the Chiba Cancer Center, The University of Tokyo Hospital, National Cancer Center Hospital, and Saitama Medical Center, Jichi Medical University. 123Clin Orthop Relat Res (2016) 474:2044-2052 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® scoring system, although a considerable ceiling effect was observed, with 23 patients (23%) given the maximum score. Cronbach's alpha coefficient was 0.87 (95% CI, 0.82-0.90), suggesting a high level of internal consistency. F...

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“…12 Limb salvage surgery patients have better quality of life without compromising survival than those who have undergone amputation. [13][14][15] Developments in adjuvant therapies, imaging diagnostics and surgical reconstructive techniques have made limb salvage surgery a preferred procedure for most primary sarcomas of the upper limbs with survival rates of 60-70%. 16,17 Today, major amputations are avoidable in most cases if the full potential of reconstructive possibilities is tapped.…”

Section: Discussionmentioning

confidence: 99%

“…13 The amputation of the upper arm would probably destroy the mental strength of the patient completely. For that reason, the preservation of the upper arm might be more emotionally acceptable than amputation, and the optimal method was en bloc resection and prosthesis implantation.…”

Section: Discussionmentioning

confidence: 99%

En bloc resection and prosthesis implantation to treat malignant fibrous histiocytoma of the humerus

Sun¹,

Zhang²,

Zheng³

2017

Adv Clin Exp Med

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Functional outcomes and quality of life in patients with osteosarcoma treated with amputation versus limb-salvage surgery: a systematic review and meta-analysis

Abstract: This meta-analysis including six high-quality studies indicates that amputation and limb-salvage surgery provide similar functional outcomes and quality of life for patients with osteosarcomas.

Cited by 57 publications

References 28 publications

A meta-analysis of randomized control trials of surgical methods with osteosarcoma outcomes

A meta-analysis of randomized control trials of surgical methods with osteosarcoma outcomes

Reliability and Validity of a Japanese-language and Culturally Adapted Version of the Musculoskeletal Tumor Society Scoring System for the Lower Extremity

En bloc resection and prosthesis implantation to treat malignant fibrous histiocytoma of the humerus

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