A Comparison of Limb Salvage Versus Amputation for Nonmetastatic Sarcomas Using Patient-reported Outcomes Measurement Information System Outcomes

Abstract

Introduction: The Patient-reported Outcomes Measurement Information System (PROMIS) is a scoring tool that allows comparisons between patients with rare conditions and more common ailments, or the general US population. PROMIS outcomes were compared between the limb salvage and amputee patients for nonmetastatic sarcomas to the US population. Methods: One hundred thirty-eight patients were included in the analysis. Patients were divided into the limb salvage and amputee cohorts, as well as based on the follow-up (1 to 11 or 12+ months). Results: Seven PROMIS domains were evaluated, and higher scores were found in both the limb salvage group and patients >12 months from surgery. The limb salvage group also had improved emotional health compared with the US population. Discussion: Improvements in PROMIS values are observed in limb salvage patients and in patients >12 months from surgery. Limb salvage patients demonstrate improved emotional health compared with the US population.

PROMIS scores of patients undergoing neoadjuvant and adjuvant radiation therapy for surgically excised soft tissue sarcoma

“…The current study seems consistent, as it found no difference in PROMIS outcomes in patients undergoing pre- versus post-operative RT at later timepoints of median 52 and 72 days, respectively. Indeed, multiple studies have shown functional recovery in patients following STS resection that continues for up to two years after an initial decline [32] , [33] , [34] , [35] .…”

Targeted muscle reinnervation in oncologic amputees: Early experience of a novel institutional protocol

“…All of this occurs in the setting of a comprehensive cancer center where a close relationship exists between medical, radiation, and surgical oncologists who work together to address cancer-specific considerations in the oncologic amputee population.In our study, TMR reduced patient-reported phantom and residual limb pain behavior and interference compared to unselected general oncologic amputee controls beyond the clinically meaningful threshold for this population. Raw PROMIS pain interference scores in our study population undergoing amputation with concurrent TMR for oncologic diagnoses demonstrated favorable outcomes in comparison to both oncologic amputees and limb salvage patients in the recent study by Wilke et al89 In a population with similar follow-up, they demonstrated PROMIS pain interference scores of 53.8 and 53.3 for limb salvage and amputation respectively. These are both higher (more pain interference) than our findings of phantom pain related pain interference of 42.1 and 46.2 for >1 year and <1 year follow-up, respectively, and residual limb pain related pain interference of 44.0 and 44.1 for >1 year and <1 year follow-up, respectively, after TMR.…”

Amputation for Extremity Sarcoma: Indications and Outcomes

“…There are some studies including only subgroups as soft tissue sarcomas but they ended with small numbers such as 18 [13] or 39 [21]. Even mixed groups of bone and soft tissue sarcomas from recent years reached sometimes only small numbers, such as 24 [22]. If the authors try to focus on location as distal tibia and entity as osteosarcoma, the resulting numbers are as small as 19 amputations even in a large center such as the Rizzoli [12], or 25 patients with soft tissue sarcoma of the extremities at Mount Sinai Hospital, Toronto [23].…”