| Alan et al.1717. Alan W, Yasko AW, Reece GP, Gillis TA, Pollock RE. Limb-salvage strategies to optimize quality of life: the M.D. Anderson Cancer Center experience. CA Cancer J Clin. 1997;47(4):226-38.
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USA 1997 |
Assess the QOL of patients who underwent limb-sparing surgery or amputation of lower or upper limb. |
Cross-sectional study N = 4 QOL = Instruments to measure psychosocial function, economic and overall well-being, and Beck Depression Inventory |
The impact of treatment on QOL is based on the capacity to preserve structures necessary for function to meet the patient's expectations with appropriate oncologic treatments and on providing a rehabilitation program that can be followed in the long-term to improve functionality. The most used measures of QOL included measures of physical, psychosocial, economic and overall well-being. |
| Yonemoto et al.1818. Yonemoto T, Ishii T, Takeuchi Y, Kimura K, Hagiwara Y, Iwata S, et al. Evaluation of QOL (QOL) in long-term survivors of high-grade osteosarcoma: A Japanese single center experience. Anticancer Res. 2007;27(5B):3621–4.
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JAPAN 2007 |
Assessment of the long-term QOL of osteosarcoma survivors who underwent amputation or limb-sparing surgery. |
Prospective Cohort Study N =33 QOL = SF 36 |
The group of patients who underwent limb-sparing surgery had higher QOL scores than the group of amputation patients. There were no differences in function between patients who underwent amputation and those who did not. Side effects related to treatment, such as secondary neoplasms and infertility, were rare. |
| Ottaviani et al.1919. Ottaviani J, Jaffe N. The Epidemiology of Osteosarcoma. In.: Jaffe N, Bruland OS, Bielack S. Pediatric and Adolescent Osteosarcoma. Cancer Treatment and Research. 2009;152:573–5. Ed. Springer.
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USA 2009 |
Assess the QOL of osteosarcoma survivors who underwent amputation or limb-sparing surgery. |
Review study N = not reported QOL = SF36, Beck Depression Inventory |
QOL in terms of functionality, psychological success, and effects on marriage and work did not differ significantly between patients with osteosarcoma who underwent amputation and those who did not. However, amputation patients appear to have made satisfactory adjustments to their deficits with or without a functional external prosthesis. |
| Griesser et al.2020. Griesser MJ, Gillette B, Crist M, Pan X, Muscarella P, Scharschmidt T, et al. Internal and External Hemipelvectomy or Flail Hip in Patients with Sarcomas. Am J Phys Med Rehabil. 2012;91(1):24–32.
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USA 2012 |
Assess the QOL of patients who underwent hip amputation or conservative surgery. |
Retrospective cohort study N = 15 QV = SF36 |
There was no statistical difference with regard to QOL and functionality between the groups. The patients' age had an impact on physical performance (the older the patient, the worse the physical performance). Because of the small number of participants, it was not possible to observe statistically significant differences between the two groups. |
| Zahlten-Hinguranage et al.2121. Zahlten-Hinguranage A, Bernd L, Ewerbeck V, Sabo D. Equal QOL after limb-sparing or ablative surgery for lower extremity sarcomas. Br J Cancer. 2004;91(6):1012–4.
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GERMANY 2004 |
Assess the QOL and functionality of patients with lower-limb sarcoma who underwent amputation or limb-sparing surgery. |
Retrospective cohort study N = 124 QOL = EORTC QLQC30 |
The results of the assessments of QOL were similar in both groups and the functionality scores were slightly higher among the patients who underwent limb-sparing surgery. The results showed that there is no advantage of limb-sparing surgery over amputation with regard to overall QOL. |
| Aksnes et al.2222. Aksnes LH, Bauer HCF, Jebsen NL, Folleras G, Allert C, Haugen GS, et al. Limb-sparing surgery preserves more function than amputation: A Scandinavian Sarcoma Group Study Of 118 Patients. J Bone Jt Surg Br. 2008;90–B(6):786–94.
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SWEDEN and NORWAY 2008 |
Assessment of the long-term QOL and functionality of patients with sarcoma who underwent limb-sparing surgery or amputation. |
Prospective cohort study N = 118 QOL = SF36 |
Patients who underwent amputation above the knee had lower functionality scores than patients who underwent limb-sparing surgery. There was no difference in QOL between patients who underwent amputation and to limb-sparing surgery. It was concluded that the majority of bone tumor survivors adapted to their physical limitations, were able to work, and had a good overall QOL. |
| Beck et al.2323. Beck LA, Einertson MJ, Winemiller MH, DePompolo RW, Hoppe KM, Sim FF. Functional outcomes and QOL after tumor-related hemipelvectomy. Phys Ther. 2008;88(8):916–27.
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USA 2008 |
Assess functional ability and QOL of patients with sarcoma who underwent hip amputation/disarticulation or conservative surgery. |
Retrospective cohort study N = 97 QOL = EORTC QLQC30 |
There was no difference in functionality between the two groups; however, patients who underwent amputation/disarticulation had more phantom pain and greater intestinal/bladder involvement. There was no difference in QOL between the two groups. The majority of the participants of both groups were fully independent with regard to transportation, mobility, eating, and personal hygiene. |
| Rougraff et al2424. Rougraff B, Simon M, Kneisl J, Greenberg D, Mankin H. Limb Salvage Compared with Amputation for Osteosarcoma of the Distal End of the Femur. A Long-Term Oncological, Functional, and Quality-of-Life Study. The Journal of Bone and Joint Surgery-American Volume. 76(5):649–656, MAY 1994.
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USA 1994 |
Assessment of the long-term functional ability and QOL of patients with osteosarcoma of the distal femur who underwent limb-sparing surgery or amputation. |
Prospective cohort study N = 127 QOL = Instruments to measure psychosocial function and Beck Depression Inventory |
There were no significant differences in survival rates or in the duration of disease-free periods after surgery between the two groups. Patients who underwent limb-sparing surgery had higher functionality scores than those who underwent amputation. No difference was observed between the groups with regard to the patient's acceptance of the postoperative state, walking ability, or amount of pain. There was no apparent difference in psychosocial or QOL outcomes between the groups. |
| Gary et al2525. Gary E, Mason GE, Aung L, Gall S, Meyers PA, Butler R, Krüg S, et al. QOL Following Amputation or Limb Preservation in Patients with Lower Extremity Bone Sarcoma. Front Oncol. 2013;3:210.
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USA 2013 |
Assess the overall QOL of lower-limb sarcoma survivors who underwent amputation or limb-sparing surgery. |
Original article N = 82 QOL = QOL Questionnaire (QLQ), Minnesota Multiphasic Personality Inventory, and Visual Analog Scale |
The overall QOL of the patients who underwent limb-sparing surgery was significantly better than that of patients who underwent amputation (p < 0.01). Significant differences were observed with regard to economic well-being, professional satisfaction, and occupational relationships. |
| Ronald et al.2626. Ronald D, Barr RD, Wunder JS. Bone and soft tissue sarcomas are often curable - But at what cost? A call to arms (and legs). Cancer. 2009;115(18):4046–54.
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CANADA 2009 |
Assess published studies on QOL and functionality of sarcoma survivors who underwent limb-sparing surgery or amputation. |
Review study N = 2710 QOL = SF 36 |
Most studies showed that the functional outcomes were better among patients who underwent limb-sparing surgery than among those who underwent amputation. There were no differences in QOL between the groups. |
