Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Kapper, M.
Sarcomas of the ankle region: quality of life and functional outcome of limb-salvage vs. amputation
Humanmedizin; [ Diplomarbeit ] Medizinische Universitaet Graz; 2021. pp. 95
[OPEN ACCESS]
FullText
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Leithner Andreas
- Smolle Maria Anna
- Altmetrics:
- Abstract:
- Introduction: Considering the dimension of the affected region, ankles sarcomas are relatively rare within the group of musculoskeletal tumours. Most studies only focus on surgical and functional outcome when comparing limb-salvage surgery versus amputation in treatment of ankle sarcomas. Yet, little attention has so far been paid to patients’ quality of life. This thesis outlines parameters for quality of life, lifestyle and functional outcome of patients treated for sarcomas of the ankle region at a tertiary sarcoma centre (Department of Orthopaedics and Trauma, Medical University of Graz). In addition, the data collected from the database of the study centre were retrospectively analysed with the focus on postoperative complications. Material and Methods: All patients treated at the study centre between 1998 and 2017 for primary bone and soft tissue sarcomas of the ankle region were retrospectively included, resulting in 24 patients eligible. Rate of postoperative complications was analysed. A p-value < 0.05 was accepted as statistically significant. In addition, patients were invited to participate in the prospective part of the study, consisting of a medical consultation, clinical examination and questionnaire survey at the study centre to collect data about quality of life, lifestyle and functional outcome. In total, 7 patients were prospectively enrolled. Results: The retrospective data evaluated in this thesis shows that 91.7% of postoperative complications after the first surgery occurred in the group of patients treated by limb-salvage procedure. The most common postoperative complications were soft tissue complications (46%) and mechanical complications (27%). In addition, all patients with postoperative complications needed revision surgery. In the prospective part of the current study, no significant difference in quality of life between patients treated with limb-salvage procedure versus patients undergoing amputation was found. However, certain tendencies were observed: A difference beyond average (approximately one standard deviation (SD)) in the T-score between the two study groups limb salvage group (LSG) and amputation group (AG) was present in the questionnaires testing for physical ability (PROMIS), physical disability (TESS) and patients’ overall life satisfaction (FLZ). However, these per tendency favorable outcome scores for patients in the LSG did not reach statistical significance (all p>0.05). Conclusion: In conclusion, postoperative complications such as soft tissue complications and mechanical complications occur more frequently in patients with limb-salvage surgery and most commonly require re-operation. Furthermore, there seems to be no significant difference between patients with limb salvage and those with amputation with regards to functional outcome. Regarding the patients’ physical ability, physical disability and overall life satisfaction, certain tendencies in favor of limb salvage surgery were present, though. Consequently, risks and benefits of limb salvage vs. amputation should be carefully weighed against each other in patients with sarcomas of the ankle region, in order to minimise the risk of surgery-associated complications, improve oncological outcome, optimize functional results, and maintain quality of life.