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Quality of Life After Hyperthermic Isolated Limb Perfusion for Locally Advanced Extremity Soft Tissue Sarcoma

¹ Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700, RB Groningen, The Netherlands
² Department of Psychosocial Services, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

Correspondence: Address correspondence and reprint requests to: Harald J. Hoekstra, MD, PhD; E-mail: h.j.hoekstra{at}chir.umcg.nl.

Background: Quality of life (QoL) and posttraumatic stress symptoms (PTSS) were studied in patients with soft tissue sarcoma (STS) of the extremities treated with isolated limb perfusion and delayed resection, with or without adjuvant irradiation.

Methods: Forty-one patients received a questionnaire that included the RAND-36 and Impact of Event Scale.

Results: Thirty-nine STS survivors (16 [41%] male and 23 [59%] female; median age, 59 years; range, 15–78 years) participated in the questionnaire survey (response rate, 95%). The median age at perfusion was 49 years (range, 14–72 years). No significant differences were found in mean scores between STS survivors and the reference group with the exception of a worse physical functioning. Patients with amputations showed significantly worse physical and social functioning and more role limitations than patients whose limbs were saved. Eleven patients (28%) had a PTSS score of 0, and eight patients (20.5%) had a score 26, which suggested the need for psychological counseling. None of these eight patients had lost a limb. Patients who indicated that the choice of treatment was made by the surgeon rather than collaboratively showed significantly decreased social functioning, more role limitations, and intrusion. Greater treatment satisfaction was significantly related to better social functioning, more vitality, better general health perception, less intrusion, avoidance, and total Impact of Event Scale scores.

Conclusions: Even though STS survivors’ QoL was different from that of a reference group only in physical functioning, one fifth of the patients had PTSS. An amputation, the physician’s decision rather than the patient’s decision for the perfusion treatment and a low satisfaction with the performed treatment negatively influenced QoL.

Key Words: Sarcoma • Isolated limb perfusion • Quality of life • Stress response symptoms

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