Patient expectations for surgical outcome in extremity soft tissue sarcoma.
OBJECTIVE
Patients' expectations regarding their surgical recovery can significantly influence health outcomes. This study examines the relationship between pre-treatment outcome expectations and post-operative function and health-related quality of life (HRQoL) in patients with extremity soft tissue sarcoma (ESTS). Additionally, we evaluate predictors of patients' outcome expectations.


METHODS
Data were prospectively collected on 157 ESTS patients (62% male, mean age 56 years) treated with limb-preservation surgery between January 2001 and February 2005. Associations between patients' outcome expectations and 1-year function and HRQoL outcomes were evaluated using multivariable regression analyses. Factors predicting patient expectations were investigated using multinomial logistic regression.


RESULTS
Patients expecting a difficult recovery and patients with uncertain expectations had worse functional outcomes than patients anticipating an easy recovery. Education, dispositional optimism, tumor location, AJCC stage, and baseline function/HRQoL were significant predictors of patient expectations. For example, patients with primary school education more frequently reported uncertain expectations regarding length of recovery (OR = 20; 95% CI, 3.7-108.6) and complications (OR = 12; 95% CI, 2.7-58.0) than patients with post-secondary education.


CONCLUSIONS
Patient expectations significantly influence functional outcome in ESTS. Patients at risk for uncertain expectations may benefit from additional, individualized education so as to optimize their treatment outcomes.
Davidge
Kristen
K
Division of Plastic Surgery, University of Toronto, Toronto, Ontario, Canada. kristen.davidge@utoronto.ca
Bell
Robert
R
Ferguson
Peter
P
Turcotte
Robert
R
Wunder
Jay
J
Davis
Aileen M
AM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D015331:Cohort Studies; D004522:Educational Status; D005121:Extremities / Q000601:surgery; D005260:Female; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D013997:Time Factors