Ablative versus limb salvage procedures in lower extremity bone tumors - Ten years results

Aim: The treatment of choice for local tumor control was amputation in the 1970's. Nowadays, limb salvage procedures have become the new standard, imp licating that limb salvage surgery results in a better quality of life. Thi s study attempts to prove this hypothesis. Method: In total, 102 patients w ho survived longer than ten years after tumor treatment of the lower extrem ities were investigated, of these, 71 patients underwent ablative procedure s compared to 31 patients with limb salvage surgery. Operative revisions, e ducation level, and occupational situation were evaluated in both groups. T o analyze the outcome of every patient regarding functional results, qualit y of life, life contentment, and social parameters, the functional evaluati on system of the Musltulo-Skeletal-Tumor Society (MSTS), the Frei-burger Li fe-Contentment-Questionnaire (FLZ) and the Quality of Life Questionnaire (Q LQ-C-30) of the European Organization of Research and treatment of Cancer ( EORTC) were used. Results: Patients treated with a limb salvage procedure u nderwent more surgical revisions (p < 0.000). Educational level and occupat ional situation showed no difference in both groups. Functional results rea ched similar levels in both groups (74.6% vs. 73.8%). Life contentment and Quality of Life measurements showed good results in both groups. The FLZ-qu estionnaire showed significantly better results for the ablative group in s ome items. Conclusion: The type of surgical local therapy of lower extremit y tumors has no measurable effect on quality of life according to long-term follow-up in lower extremity tumors. In cases with a risk of inadequate ma rgins when performing limb salvage surgery, an ablative procedure should be preferred.