The Influence of Anatomic Location on Functional Outcome in Lower-Extremity Soft-Tissue Sarcoma
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Background: The purpose of this study was to explore the relationship between the anatomical location of lower-extremity soft-tissue sarcoma and functional outcome.
Methods: Function was evaluated with the Musculoskeletal Tumor Society (MSTS 1993) score and Toronto Extremity Salvage Score (TESS); 207 patients (median age, 54 years) were eligible. The median maximum tumor diameter was 8.0 cm; 58 tumors were superficial and 149 were deep. Nine locations based on anatomical compartments were defined: 6 tumors were in the groin/femoral triangle; 8, the buttock; 52, the anterior thigh; 22, the medial thigh; 20, the posterior thigh; 10, the popliteal fossa; 13, the posterior calf; 11, the anterolateral leg; and 7, the foot or ankle.
Results: Treatment of superficial tumors did not lead to significant changes in MSTS score (mean, 90.6% preoperatively vs. 93.0% postoperatively; P = .566) or TESS (mean, 86.4% preoperatively vs. 90.9% postoperatively; P = .059). Treatment of deep tumors lead to significant reductions in MSTS score and TESS (mean MSTS, 86.9% preoperatively vs. 83.0% postoperatively; P = .001; and mean TESS, 83.0% preoperatively vs. 79.4% postoperatively; P = .015). Anatomical location was not a significant predictor of aggregated MSTS and TESS evaluations. Exploratory analysis showed variation in MSTS pain and gait handicap or limp items and TESS dressing, sitting, bending, and bathing items by anatomical location.
Conclusions: The treatment of superficial tumors does not lead to significant changes in MSTS score or TESS. Anatomical location is not a significant predictor of aggregated MSTS and TESS evaluations. However, there is variation in MSTS and TESS item scores across anatomical locations.
- Lampert MH, Gerber LH, Glatstein E, Rosenberg SA, Danoff JV. Soft tissue sarcoma: functional outcome after wide local excision and radiation therapy. Arch Phys Med Rehabil 1984;65:477–80.
- Robinson MH, Spruce L, Eeles R, et al. Limb function following conservation treatment of adult soft tissue sarcoma. Eur J Cancer 1991;27:1567–74.
- Enneking WF. Modification of the system for functional evaluation in the surgical management of musculoskeletal tumors. Enneking WF Eds. Limb Salvage in Musculoskeletal Oncology New York: Churchill Livingstone, 1987: 626–39
- Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop 1993;286:241–6.
- Sugarbaker PH, Barofsky I, Rosenberg SA, Gianola FJ. Quality of life assessment of patients in extremity sarcoma clinical trials. Surgery 1982;91(1):17–23.
- World Health Organization. International Classification of Impair-ments, Disabilities and Handicaps. Geneva: World Health Orga-nization, 1980.
- Davis AM, Sennik S, Griffin AM, et al. Predictors of functional outcomes following limb salvage surgery for lower-extremity soft tissue sarcoma. J Surg Oncol 2000;73:206–11.
- Davis AM, Wright JG, Williams JI, Bombardier C, Griffin A, Bell RS. Development of a measure of physical function for patients with bone and soft tissue sarcoma. Qual Life Res 1996;5:508–16.
- Davis AM, Bell RS, Badley EM, Yoshida K, Williams JI. Evaluating functional outcome in patients with lower extremity sarcoma. Clin Orthop 1999;358:90–100.
- Bell RS, O’Sullivan B, Davis A, Langer F, Cummings B, Fornasier VL. Functional outcome in patients treated with surgery and irradiation for soft tissue tumours. J Surg Oncol 1991;48:224–31.
- Enneking WF, Spanier SS, Malawer MM. The effect of the anatomic setting on the results of surgical procedures for soft parts sarcoma of the thigh. Cancer 1981;47:1005–22.
- The Influence of Anatomic Location on Functional Outcome in Lower-Extremity Soft-Tissue Sarcoma
Annals of Surgical Oncology
Volume 11, Issue 5 , pp 476-482
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Lower extremity
- Soft-tissue sarcoma
- Anatomical site
- Functional outcome
- Industry Sectors
- Author Affiliations
- 1. University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto and Princess Margaret Hospital, Toronto, Canada
- 2. Room 1119, Toronto Rehabilitation Institute, 550 University Avenue, Toronto, Ontario, Canada, M5G 2A2