Best Treatment for Lower Extremity Sarcoma Unknown

Need for more studies comparing impact, benefit of limb salvage surgery with amputation
By Lisa Cockrell, PhD
HealthDay Reporter

MONDAY, Aug. 10 (HealthDay News) -- Despite a lower prevalence of amputations, limb salvage surgery may not offer a more effective outcome for health-related quality of life (HRQoL) for younger individuals with bone and soft tissue sarcomas of the leg, according to a review published online Aug. 10 in Cancer.

Ronald D. Barr, M.D., of McMaster University in Hamilton, Canada, and colleague performed a review of studies of individuals who were diagnosed with cancer as a child. Although there is a lack of robust data, the present evidence largely suggests that HRQoL is similar between those patients who underwent limb salvage surgery and those who had limb amputations. Some reports actually suggest improved HRQoL with amputation.

In an economic evaluation of surgical alternatives for younger individuals with tumors in the lower extremities, the up-front costs associated with salvaging the limb were found to likely be a trade-off for the maintenance costs associated with limb amputation. The authors of the review conclude that a more formal economic evaluation would likely help guide future decisions regarding limb salvage surgery.

"Although it appears that the number of amputations per year has decreased with time, it cannot be assumed that limb salvage surgery will offer a better functional outcome and HRQoL for young people with bone and soft tissue sarcomas of the lower limb. Although this challenge is clearly a moving target, formal economic evaluation would make a useful contribution to future decision making by patients and their health care providers, surgeons, and others alike," the authors write.

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