Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Büchner, T.
Tumors of the Hand; Is our surgery reaching patients expectations?
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2017. pp. 78
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Bergovec Marko
- Leithner Andreas
- Altmetrics:
- Abstract:
- Background: Surgical therapy is crucial for convalescence of patients and prevention of relapse, based on clinical and pathomorphological outcome parameters, in the majority of hand and distal forearm tumors. However, it remains to be elucidated how surgery impacts the patients’ quality of life, as well as their hands’ functional status. Regarding distal upper extremities affected by diverse tumor dignities, insufficient amount of data is available on the subject of determining post-operative health related quality of life. Methods: We conducted a retrospective analysis of medical records and the tumor database at the Department of Orthopedics and Orthopedic Surgery, Medical University of Graz. All patients operated for hand or distal forearm tumors between January 2004 and March 2015 were included in our study. Study participants were sent three questionnaires: SF 12 questionnaire to determine the general health status, DASH (Disability of Arm Shoulder and Hand) to measure function and symptoms, and a questionnaire on social status and patients’ personal pre-operative expectations and post-operative satisfaction. Results: The response rate was 39.2%, i.e. 49 questionnaires out of 125 have been returned. Gender distribution was 55% women and 45% men, with an average age of 54 years (range: 22-84 years). The majority of tumor dignities present in the study population were Giant-Cell tumors of the tendon sheath with 30.6% (n=16). Malignant tumors represented 16.3% (n=8) of all tumor dignities. Regarding general health (SF 12), most patients were satisfied with their current health, only four and one of the patients estimated their health status as fair and poor, respectively. Overall DASH-Score was 11.26; Sub- analysis for tumor dignity showed an average DASH-Score 25.8 for malignant tumors, 9 in case of semi-malignant and 7.6 in the benign group. Regarding socioeconomic factors we found a trend to a weak negative correlation (Spearman’s Rho=-0.24, p=0.125) between income and subjective restriction. Conclusion: The majority of patients who underwent tumor surgery are satisfied with the outcome of the procedure. However, higher grade in malignancy results in a poorer outcome due to the higher invasivity of the operation. For further clarification regarding patient related outcome measures in tumor surgery, a larger cohort with uniform baseline demographics, as well as additional outcome measures will be needed to achieve more detailed results.