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Archives of Orthopaedic and Trauma Surgery

, Volume 134, Issue 11, pp 1507–1516 | Cite as

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

  • Jiong Mei
  • Xiao-Zhong Zhu
  • Zhi-Yuan Wang
  • Xuan-Song Cai
Orthopaedic Surgery

Abstract

Introduction

To perform a meta-analysis for comparing the functional outcomes and quality of life (QOL) of osteosarcoma patients receiving amputation or limb-salvage surgeries.

Materials and methods

A search was conducted of the Medline, Cochrane, EMBASE, and Google Scholar on September 30, 2013. Studies were included in the analysis if there were patients who underwent amputation and limb-salvage surgery for osteosarcoma or Ewing’s sarcoma, and for whom postoperative functional outcomes and QOL were evaluated. Outcomes were compared between participants who underwent limb-salvage operation and those who underwent amputation. The methodological quality of non-randomized comparative studies was assessed using the Newcastle–Ottawa Scale.

Results

A total of 121 studies were identified and 6 were included in the meta-analysis. Quality assessment indicated that all six studies were of high quality. The mean age of the participants ranged from 17 to 37 years, and among them 118 underwent amputations and 138 underwent limb-salvage procedures. The mean length of follow-up ranged from 28 to 145 months. The meta-analysis indicated that functional outcomes and QOL were similar between patients who underwent amputation and those who underwent a limb-salvage procedure.

Conclusions

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.

Keywords

Osteosarcoma Ewing’s sarcoma Amputation Limb salvage Quality of life Function 

Abbreviations

SMD

Standardized mean difference

CI

Confidence interval

MSTS

System for functional evaluation of the American Musculoskeletal Tumor Society

TESS

Toronto Extremity Salvage Score

SF-36

Short form 36

PF

Physical functioning

RP

Physical role

BP

Bodily pain

GH

General health perceptions

VT

Vitality

SF

Social functioning

RE

Emotional role

MH

Mental health

PCS

Physical component summary

MCS

Mental component summary

HR

Hazard ratio

NA

Not available

Notes

Conflicts of interest

None to declare.

Supplementary material

402_2014_2086_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 12 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Jiong Mei
    • 1
  • Xiao-Zhong Zhu
    • 1
  • Zhi-Yuan Wang
    • 1
  • Xuan-Song Cai
    • 1
  1. 1.Department of OrthopaedicsTongji Hospital of Tongji UniversityShanghaiChina

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