PMID- 34389213
OWN - NLM
STAT- MEDLINE
DCOM- 20220504
LR  - 20221207
IS  - 1532-2157 (Electronic)
IS  - 0748-7983 (Linking)
VI  - 48
IP  - 3
DP  - 2022 Mar
TI  - Health-related quality of life after isolated limb perfusion compared to extended 
      resection, or amputation for locally advanced extremity sarcoma: Is a limb 
      salvage strategy worth the effort?
PG  - 500-507
LID - S0748-7983(21)00676-4 [pii]
LID - 10.1016/j.ejso.2021.08.007 [doi]
AB  - INTRODUCTION: The aim of this study was to compare long-term patient reported 
      outcomes (PROs) in patients with locally advanced extremity soft tissue sarcoma 
      (eSTS) after isolated limb perfusion followed by resection (IR), compared to 
      extended resection (ER), primary amputation (A) or secondary amputation after IR 
      (IR-A). METHODS: Patients were selected from the respondents of a 
      multi-institutional cross-sectional cohort survivorship study (SURVSARC) 
      conducted among sarcoma survivors registered in the Netherlands Cancer Registry 
      (NCR), 2-10 years after diagnosis. Used PROs were the EORTC QLQ-C30, the Cancer 
      worry scale (CWS), the Hospital Anxiety and Depression Scale (HADS), and the 
      Toronto Extremity Salvage Score (TESS). RESULTS: We identified 97 eSTS survivors: 
      IR = 20, ER = 49, A = 20, IR-A = 8. While there were no differences in PROs 
      between IR and ER, results showed better functioning and functionality in both 
      groups versus the amputation groups. The amputation groups scored significantly 
      lower on physical functioning (A = 62.7, IR-A = 65.7 versus IR = 78.0, ER = 82.7, 
      p = 0.001) and role functioning (A = 67.5, IR-A = 52.8 versus IR = 79.2, 
      ER = 80.6, p = 0.039), both EORTC QLQ-C30 scales. Also for the TESS, the scores 
      were significantly lower for the amputation groups compared to the limb sparing 
      groups (upper extremity p = 0.007 with A = 68.9, IR-A = 71.6 versus IR = 93.3, 
      ER = 91.1; lower extremity p < 0.001 with A = 72.2, IR-A50.9 versus IR = 84.5 and 
      ER = 85.5). There were no significant differences between the groups on cancer 
      worry, anxiety and depression. CONCLUSION: HRQoL in eSTS survivors treated with 
      IR or ER is equal; for maintenance of physical functioning and functionality IR 
      and ER outperform an amputation.
CI  - Copyright (c) 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the 
      European Society of Surgical Oncology. All rights reserved.
FAU - Reijers, Sophie J M
AU  - Reijers SJM
AD  - Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the 
      Netherlands.
FAU - Husson, Olga
AU  - Husson O
AD  - Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the 
      Netherlands; Division of Psychosocial Research and Epidemiology, Netherlands 
      Cancer Institute, Amsterdam, the Netherlands; Division of Clinical Studies, 
      Institute of Cancer Research, London, United Kingdom.
FAU - Soomers, Vicky L M N
AU  - Soomers VLMN
AD  - Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the 
      Netherlands.
FAU - Been, Lukas B
AU  - Been LB
AD  - Department of Surgical Oncology, University Medical Center Groningen, Groningen, 
      the Netherlands.
FAU - Bonenkamp, Johannes J
AU  - Bonenkamp JJ
AD  - Department of Surgical Oncology, Radboud University Medical Center, Nijmegen, the 
      Netherlands.
FAU - van de Sande, Michiel A J
AU  - van de Sande MAJ
AD  - Department of Orthopaedic Oncology, Leiden University Medical Center, Leiden, the 
      Netherlands.
FAU - Verhoef, Cornelis
AU  - Verhoef C
AD  - Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University 
      Medical Center, Rotterdam, the Netherlands.
FAU - van der Graaf, Winette T A
AU  - van der Graaf WTA
AD  - Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the 
      Netherlands; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus 
      University Medical Center, Rotterdam, the Netherlands.
FAU - van Houdt, Winan J
AU  - van Houdt WJ
AD  - Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the 
      Netherlands. Electronic address: w.v.houdt@nki.nl.
LA  - eng
PT  - Journal Article
DEP - 20210808
PL  - England
TA  - Eur J Surg Oncol
JT  - European journal of surgical oncology : the journal of the European Society of 
      Surgical Oncology and the British Association of Surgical Oncology
JID - 8504356
SB  - IM
MH  - Amputation, Surgical
MH  - Cross-Sectional Studies
MH  - Follow-Up Studies
MH  - Humans
MH  - Limb Salvage/methods
MH  - Lower Extremity/surgery
MH  - *Neoplasms, Second Primary/surgery
MH  - Perfusion
MH  - Quality of Life
MH  - *Sarcoma/surgery
MH  - *Soft Tissue Neoplasms/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Amputation
OT  - Isolated limb perfusion
OT  - Quality of life
OT  - Soft tissue sarcoma
COIS- Declaration of competing interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2021/08/15 06:00
MHDA- 2022/05/06 06:00
CRDT- 2021/08/14 05:39
PHST- 2021/04/20 00:00 [received]
PHST- 2021/07/12 00:00 [revised]
PHST- 2021/08/06 00:00 [accepted]
PHST- 2021/08/15 06:00 [pubmed]
PHST- 2022/05/06 06:00 [medline]
PHST- 2021/08/14 05:39 [entrez]
AID - S0748-7983(21)00676-4 [pii]
AID - 10.1016/j.ejso.2021.08.007 [doi]
PST - ppublish
SO  - Eur J Surg Oncol. 2022 Mar;48(3):500-507. doi: 10.1016/j.ejso.2021.08.007. Epub 
      2021 Aug 8.