A comparative analysis of functional outcomes in adolescents and young adults with lower-extremity bone sarcoma.
BACKGROUND
Comparison of functional mobility and quality of life is performed in patients with lower-extremity bone sarcoma following either amputation, limb-sparing surgery, or rotationplasty with four different types of outcome measures: (1) an objective functional mobility measure that requires patients to physically perform specific tasks, functional mobility assessment (FMA); (2) a clinician administered tool, Musculoskeletal Tumor Society Scale (MSTS); (3) a patient questionnaire, Toronto Extremity Salvage Scale (TESS); and (4) a health-related quality of life (HRQL) measure, Short Form-36 version 2 (SF-36v.2).


METHODS
This is a prospective multi-site study including 91 patients with lower-extremity bone sarcoma following amputation, limb-sparing surgery, or rotationplasty. One of three physical therapists administered the quality of life measure (SF-36v.2) as well as a battery of functional measures (FMA, MSTS, and TESS).


RESULTS
Differences between patients who had amputation, limb-sparing surgery, or rotationplasty were consistently demonstrated by the FMA. Patients with limb sparing femur surgery performed better than those patients with an above the knee amputation but similarly to a small number of rotationplasty patients. Several of the more conventional self-report measures were shown to not have the discriminative capabilities of the FMA in these cohorts.


CONCLUSIONS
In adolescents with lower-extremity bone sarcoma, it may be advantageous to consider the use of a combination of outcome measures, including the FMA, for objective functional mobility assessment along with the TESS for a subjective measure of disability and the SF-36v.2 for a quality-of-life measure.
Ginsberg
Jill P
JP
Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. ginsbergji@email.chop.edu
Rai
Shesh N
SN
Carlson
Claire A
CA
Meadows
Anna T
AT
Hinds
Pamela S
PS
Spearing
Elena M
EM
Zhang
Lijun
L
Callaway
Lulie
L
Neel
Michael D
MD
Rao
Bhaskar N
BN
Marchese
Victoria G
VG
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical / Q000379:methods / Q000706:statistics & numerical data; D001859:Bone Neoplasms / Q000601:surgery*; D050281:Bones of Lower Extremity / Q000473:pathology* / Q000601:surgery; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D023821:Limb Salvage / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D051346:Mobility Limitation; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012399:Rotation; D012509:Sarcoma / Q000601:surgery*; D016896:Treatment Outcome