Functional outcome in amputation versus limb sparing of patients with lower extremity sarcoma: A matched case-control study
Functional outcome in amputation versus limb sparing of patients with lower extremity sarcoma: A matched case-control study
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DOI：
10.1016/s0003-9993(99)90161-2
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发表时间：
1999-06-01
影响因子：
4.3
通讯作者：
Bell, RS
中科院分区：
文献类型：
--
作者：
Davis, AM;Devlin, M;Bell, RS
目的：为了量化下肢肉瘤患者的肢体残疾和残疾的差异，需要截肢的原发肿瘤相比，肢体保留surgery.Design：匹配的病例对照研究。12名截肢患者与24名通过保肢手术治疗的患者在以下变量上匹配：年龄、性别、随访时间长度、骨与软组织肿瘤、解剖部位和辅助化疗治疗。因原发性软组织或骨肉瘤接受膝上截肢（AKA）或膝下截肢（BKA）且未发生局部或全身复发的患者，术后随访至少1年。主要结果测量：多伦多残疾救助评分（TESS），一种身体残疾的测量方法; SF-36，一种一般健康状况的测量方法;和重返正常生活（RNL），一种残疾的测量方法。截肢患者的平均TESS评分为74.5分，肢体保留患者为85.1分。（p = .15）。仅SF-36的身体功能子量表显示出统计学显著性差异，截肢组与保肢组的平均值分别为45和71.1（p = .03）。截肢组的RNL为84.4，肢体保留组为97（p = 0.05）。7的12例截肢患者经历了持续的困难与软组织覆盖their stumps.Conclusions：有一个趋势，增加残疾的截肢组与那些在肢体保留组，截肢组表现出显着较高的残疾水平。这些数据表明，截肢和肢体保留患者之间的残疾差异小于预期。这些差异在衡量残疾方面可能更显着。(C)1999年由美国康复医学大会和美国物理医学和康复学会。
Objective: To quantify the differences in physical disability and handicap experienced by patients with lower extremity sarcoma who required amputation for their primary tumor as compared with those treated by limb-sparing surgery.Design: Matched case-control study. Twelve patients with amputation were matched with 24 patients treated by limb-sparing surgery on the following variables: age, gender, length of follow-up, bone Versus soft-tissue tumor, anatomic site, and treatment with adjuvant chemotherapy.Patients: Patients who underwent above-knee amputation (AKA) or below-knee amputation (BKA) for primary soft-tissue or bone sarcoma, who had not developed local or systemic recurrence, and who had been followed up for at least 1 year since surgery.Main Outcome Measures: The Toronto Extremity Salvage Score (TESS), a measure of physical disability; the Short-form-36 (SF-36), a generic health status measure; and the Reintegration to Normal Living (RNL), a measure of handicap.Results: Mean TESS score for the patients with amputations was 74.5 versus 85.1 for the limb-sparing patients. (p = .15). Only the physical function subscale of the SF-36 showed statistically significant differences, with means of 45 and 71.1 for the amputation Versus limb-sparing groups, respectively (p = .03). The RNL for the amputation group was 84.4 versus 97 for the limb-sparing group (p = .05). Seven of the 12 patients with amputations experienced ongoing difficulty with the soft tissues overlying their stumps.Conclusions: There was a trend toward increased disability for those in the amputation group versus those in the limb-sparing group, with the amputation group showing significantly higher levels of handicap. These data suggest that the differences in disability between amputation and limb-sparing patients are smaller than anticipated. The differences may be more notable in measuring handicap. (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.