Functional outcome after surgery in patients with bone sarcoma around the knee; results from a long‐term prospective study

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Abstract

Background and Objectives

In a previous conducted study functional outcome of young patients with bone sarcoma located around the knee was longitudinally evaluated during the first 2 years postoperatively. Functional outcome improved significantly over the first 2 years. The purpose of this descriptive study was to evaluate the functional outcome of these patients at long‐term follow‐up of 7 years.

Methods

Functional outcome was assessed with the TESS, MSTS, Baecke questionnaire, and three functional performance tests: time up and down stairs (TUDS), various walking activities (VWA), and the 6‐min walking test (6MWT). Linear Mixed Model has been employed for the repeated measurements.

Results

Twenty patients of the original study ( n = 44) participated in the current study. Fifteen limb‐salvage and five ablative surgery patients, median follow‐up 7.4 years (6.8‐8.0) (CI 95%), mean age 22.3 years (18.2‐31.6). Between 2 and 7 years after surgery, 8 limb‐salvage patients (53%) encountered surgery related complications. Questionnaires and functional performance tests showed no significant difference in functional outcome between 2 years and 7 years after surgery ( P < 0.05).

Conclusions

Between 2 years and follow‐up at average 7 years after surgery no further improvements were noticed at young patients with a bone sarcoma located around the knee.

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Most cited references 21

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Osteosarcoma, chondrosarcoma, and Ewing's sarcoma: National Cancer Data Base Report.

Timothy Damron, William Ward, Andrew Stewart (2007)

We summarize descriptive epidemiologic and survival data from the National Cancer Data Base of the American College of Surgeons for 26,437 cases of osteosarcoma (n = 11,961), chondrosarcoma (n = 9606), and Ewing's sarcoma (n = 4870) from 1985 to 2003. Survival data are reported on cases with a minimum 5-year followup from 1985 to 1998 (8,104 osteosarcomas, 6,476 chondrosarcomas, and 3,225 Ewing's sarcomas). The relative 5-year survival rate was 53.9% for osteosarcoma, 75.2% for chondrosarcoma, and 50.6% for Ewing's sarcoma. Survival rates did not change notably over the collection period. Within osteosarcomas, the relative 5-year survival rates were 52.6% for high grade, 85.9% for parosteal, and 17.8% for Paget's subtypes. For osteosarcoma patients, the relative 5-year survival rate was 60% for those younger than 30 years, 50% for those aged 30 to 49 years, and 30% for those aged 50 years or older. Within chondrosarcomas, the relative 5-year survival rate was 76% for conventional, 71% for myxoid, 87% for juxtacortical, and 52% for mesenchymal. While the National Cancer Data Base has limitations, the survival data and demographics for bone sarcomas are unprecedented in numbers and duration. Our report supports continued efforts to refine data collection and stimulate further data analysis.

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Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review.

Eric Henderson, John S Groundland, Elisa Pala … (2011)

Massive endoprostheses provide orthopaedic oncologists with many reconstructive options after tumor resection, although failure rates are high. Because the number of these procedures is limited, failure of these devices has not been studied or classified adequately. This investigation is a multicenter review of the use of segmental endoprostheses with a focus on the modes, frequency, and timing of failure. Retrospective reviews of the operative databases of five institutions identified 2174 skeletally mature patients who received a large endoprosthesis for tumor resection. Patients who had failure of the endoprosthesis were identified, and the etiology and timing of failure were noted. Similar failures were tabulated and classified on the basis of the risk of amputation and urgency of treatment. Statistical analysis was performed to identify dependent relationships among mode of failure, anatomic location, and failure timing. A literature review was performed, and similar analyses were done for these data. Five hundred and thirty-four failures were identified. Five modes of failure were identified and classified: soft-tissue failures (Type 1), aseptic loosening (Type 2), structural failures (Type 3), infection (Type 4), and tumor progression (Type 5). The most common mode of failure in this series was infection; in the literature, it was aseptic loosening. Statistical dependence was found between anatomic location and mode of failure and between mode of failure and time to failure. Significant differences were found in the incidence of failure mode Types 1, 2, 3, and 4 when polyaxial and uniaxial joints were compared. Significant dependence was also found between failure mode and anatomic location in the literature data. There are five primary modes of endoprosthetic failure, and their relative incidences are significantly different and dependent on anatomic location. Mode of failure and time to failure also show a significant dependence. Because of these relationships, cumulative reporting of segmental failures should be avoided because anatomy-specific trends will be missed. Endoprosthetic design improvements should address failure modes specific to the anatomic location.

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Reference values for the 6-min walk test in healthy subjects 20-50 years old.

Margherita Neri, Panagiota Tzani, Giovanna Pisi … (2006)

In 102 healthy Caucasians, 20-50 years old, we investigated the effect of anthropometrics on the 6-min walk test (6MWT), in order to provide reference values for walk distance (6MWD), oxygen saturation (SpO2), pulse rate (PR), respiratory rate (RR), breathlessness perception (VAS) and for the walking distance and body weight product (DW). The mean 6MWD and DW values were 593 +/- 57 and 638+/-44 m (P < 0.01) and 35,030 +/- 5306 and 48,882 +/- 6555 kg m (P < 0.01), respectively for women and for men. While walking, SpO2 remained unaltered and subjects reached 67 +/- 10% of their maximal predicted heart rate and a RR mean value of 19 +/- 4 bpm. VAS ratings were significantly higher in females as compared to males (24 +/- 15 vs. 18 +/- 5 mm, P < 0.05), however, when corrected for PR change while walking, they were not different. The equation by stepwise multiple regression analysis included height, age and gender for the 6MWD and accounted for 42% of the total variance. This study confirms the relevant effect of anthropometrics on walking capacity and suggests that when rating dyspnea, the change in heart rate during walking should be considered.

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Author and article information

Contributors

Janneke C. van Egmond‐van Dam:

ORCID: http://orcid.org/0000-0001-7289-1226

j.c.van_egmond-van_dam@lumc.nl

Journal

Journal ID (nlm-ta): J Surg Oncol

Journal ID (iso-abbrev): J Surg Oncol

Journal ID (doi): 10.1002/(ISSN)1096-9098

Journal ID (publisher-id): JSO

Title: Journal of Surgical Oncology

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 0022-4790

ISSN (Electronic): 1096-9098

Publication date (Electronic): 06 April 2017

Publication date (Print): 15 June 2017

Volume: 115

Issue: 8 ( doiID: 10.1002/jso.v115.8 )

Pages: 1028-1032

Affiliations

[ ¹ ] Department of Orthopedics, Rehabilitation & Physical Therapy Leiden University Medical Centre Leiden Netherlands

[ ² ] Department of Orthopedic Surgery Academic Medical Center University of Amsterdam Amsterdam Netherlands

[ ³ ] Department of Pediatric Oncology/Hematology Erasmus MC University Medical Center‐Sophia Children's Hospital Rotterdam Netherlands

[ ⁴ ] Mathematical Institute Leiden University Leiden Netherlands

[ ⁵ ] Department of Medical Statistics and Bioinformatics Leiden University Medical Centre Leiden Netherlands

Author notes

[*] [* ] Correspondence

Janneke C. van Egmond‐van Dam, PT, Department of Orthopedics, Rehabilitation & Physical therapy, Leiden University Medical Centre, Postal zone: H0‐Q, room C‐00‐043, PO Box 9600, 2300 RC Leiden, the Netherlands.

Email: j.c.van_egmond-van_dam@ 123456lumc.nl

Author information

Janneke C. van Egmond‐van Dam http://orcid.org/0000-0001-7289-1226

Article

Publisher ID: JSO24618

DOI: 10.1002/jso.24618

PMC ID: 5516165

PubMed ID: 28384378

SO-VID: 81657d98-6327-4730-a4d2-df050582b9a2

License:

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

History

Date received : 20 October 2016

Date revision received : 03 February 2017

Date accepted : 01 March 2017

Page count

Figures: 1, Tables: 2, Pages: 5, Words: 3861

Funding

Funded by: Johanna Children Fund

Award ID: 2003/0111‐161

Funded by: Children Fund Adrian Foundation

Award ID: 2003/0111

Funded by: BIO‐Children Rehabilitation Fund

Award ID: 2003/0131‐161

Custom metadata

source-schema-version-number 2.0

component-id jso24618

cover-date June 15, 2017

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.4 mode:remove_FC converted:19.07.2017

ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: follow‐up,functional outcome,knee,malignant bone sarcoma,young patients

Data availability:

ScienceOpen disciplines: Oncology & Radiotherapy

Keywords: follow‐up, functional outcome, knee, malignant bone sarcoma, young patients

Functional outcome after surgery in patients with bone sarcoma around the knee; results from a long‐term prospective study

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Abstract

Background and Objectives

Methods

Results

Conclusions

Related collections

Karger: Oncology

Most cited references 21

Osteosarcoma, chondrosarcoma, and Ewing's sarcoma: National Cancer Data Base Report.

Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review.

Reference values for the 6-min walk test in healthy subjects 20-50 years old.

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