Limb-sparing may be a goal for patients with bone and soft tissue sarcomas, but new research from McMaster University, Hamilton, Ontario, Canada, suggests that limb-sparing surgery offers few or no quality of life, cost, or psychological benefits over amputation.
Ronald D. Barr, MB, ChB, MD, and Jay S. Wunder, MD, MSc, surveyed published literature to compared costs and benefits of amputation and limb-sparing surgeries, reviewing studies that gave functional health and quality-of-life measures for the period after each procedure.
According to their findings, published in the journal Cancer, the two methods worked equally well to eradicate cancer, but patients who underwent limb-sparing tended to present more early and late complications. Those who had lower-limb bone sarcomas showed equally good quality of life measures after either amputation or limb-sparing surgery. According to HemOnc Today, “differences in disability between the two treatments were small.”
In several studies surveyed by Barr and Wunder, no significant differences in psychological health and quality of life were found between limb-sparing surgery and amputation. Only in high transfemoral amputations and in hip disarticulation surgeries did limb-sparing surgery show benefit compared with amputation. In terms of cost, the two methods were similar. Amputation costs include long-term prosthetic care, while limb-sparing requires greater initial surgical costs, rehabilitation expenses, and expenses for revisions.
