title: Patient factors affecting the Toronto extremity salvage score following limb salvage surgery for bone and soft tissue tumors.
abstract: OBJECTIVE
  The Toronto extremity salvage score (TESS) assesses physical function following limb salvage for bone and soft tissue sarcoma. In 2012, Clayer et al. showed increasing age affects the TESS score in normal individuals. The purpose of this study was to investigate what other patient factors affect outcome?
  
  
  METHODS
  We reviewed the TESS scores, age, sex, BMI, diagnosis, smoking status, and social deprivation score of patients who have undergone limb salvage in our unit. Data were extracted from our tumor database and reviewed. Statistical analysis was performed using Wilcoxon pairwise test and linear regression analysis.
  
  
  RESULTS
  Four hundred and ninety-eight TESS scores were found for 198 patients. Data were analyzed separating upper limb (UL) and lower limb (LL) tumors. In the UL group, being female (P = 0.01) and having a bone lesion (P < 0.001) were associated with a lower TESS score. In the LL group, being female (P = 0.04), increasing age (P = 0.002), having a bone lesion (P < 0.001), increasing BMI (P < 0.001), and smoking (P = 0.005) were associated with a lower TESS score.
  
  
  CONCLUSIONS
  Analysis has shown that female sex, increasing age and BMI, smoking and having a bone lesion have an adverse effect on physical function following limb salvage, as indicated by the mean TESS score. J. Surg. Oncol. 2016;113:804-810. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Robert Jones and, Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom.
authors.forename: Catriona
authors.initials: C
authors.lastname: Heaver
authors.affiliation: Robert Jones and, Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom.
authors.forename: Antonia
authors.initials: A
authors.lastname: Isaacson
authors.affiliation: Robert Jones and, Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Gregory
authors.affiliation: Robert Jones and, Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom.
authors.forename: Gill
authors.initials: G
authors.lastname: Cribb
authors.affiliation: Robert Jones and, Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Cool
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D023821:Limb Salvage; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011184:Postoperative Period; D020127:Recovery of Function; D012509:Sarcoma / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
keywords: Toronto extremity salvage score; limb salvage; outcome; patient factors; physical disability; sarcoma