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

Abstract

Background Few studies have focused on patient-related factors in analyzing long-term functional outcome and health-related quality of life (HRQoL) in patients with postoperative lower extremity soft tissue sarcoma (STS). Objective The purpose of this study was to investigate factors associated with postoperative functional outcome and HRQoL in patients with lower extremity STS. Methods This cross-sectional study was performed in a tertiary referral center using the Toronto Extremity Salvage Score (TESS), Quality-of-Life Questionnaire (QLQ)-C30 and 15 Dimension (15D) measures. Functional outcome and HRQoL data were collected prospectively. All patients were treated by a multidisciplinary team according to a written treatment protocol. Results A total of 141 patients who had undergone limb-salvage surgery were included. Depending on the outcome measure used, 19–51% of patients were completely asymptomatic and 13–14% of patients had an unimpaired HRQoL. The mean score for TESS, 15D mobility score, and QLQ-C30 Physical Functioning scale were 86, 0.83, and 75, respectively, while the mean score for 15D was 0.88, and 73 for QLQ-C30 QoL. Lower functional outcome was statistically significantly associated with higher age, higher body mass index (BMI), and the need for reconstructive surgery and radiotherapy, while lower HRQoL was statistically significantly associated with higher age, higher BMI, and reconstructive surgery. Conclusion Functional outcome and HRQoL were generally high in this cross-sectional study of patients with STS in the lower extremity. Both tumor- and treatment-related factors had an impact but patient-related factors such as age and BMI were the major determinants of both functional outcome and HRQoL.

ASO Author Reflection: Demographic Conditions are the Major Determinants for Functional Outcome and Quality of Life in Lower Extremity Soft Tissue Sarcoma Patients

“…We performed a cross-sectional study in a tertiary referral center using the TESS, QLQ-C30, and 15D measures based on 141 patients who had undergone limb salvage surgery for lower extremity STS. 5 Mean functional outcome and HRQL were generally good and comparable to previous studies. Treatment-related factors, such as need for reconstructions and radiotherapy, had an impact, but patient-related factors (age and BMI) were the major determinants of both functional outcome and HRQL in the long term.…”

A Newly Established Cuproptosis-Associated Long Non-Coding RNA Signature for Predicting Prognosis and Indicating Immune Microenvironment Features in Soft Tissue Sarcoma

“…Despite significant improvements in the survival rate following aggressive multidisciplinary treatment encompassing surgery, radiotherapy, chemotherapy, and immunotherapy, the prognosis for patients with STSs remains poor [ 22 , 23 ]. Even when patients share the same clinical risk factors, their prognosis and treatment outcomes may vary widely [ 24 ].…”

The psychological impact of sarcoma on affected patients

“…Some studies show that the QoL of sarcoma patients appears to be stable. 2,[33][34][35][36][37][38] However, other research found more compromised levels of QoL. 39 Sarcoma patients experience lower QoL compared to the general population, 2,4,33,35,40 in different age groups, 41 even if other research detected poorer physical functioning but fewer symptoms such as fatigue and sleep disturbances in sarcoma patients than in the normative population.…”

“…55 Surgically treated patients showed overall good QoL concerning physical functioning in activities of daily living. 34,35 Amputation seems to be associated with poorer QoL outcomes, 42,50,54 whereas patients treated with limb-sparing surgery had good QoL. 37 Patients with more proximal amputations had higher levels of impairment than those with below-knee or minor amputations, particularly concerning daily activities and sexual activity.…”