Minimal clinically important differences in Toronto Extremity Salvage Score for patients with lower extremity sarcoma

Background and Aims: The present standard of care in treating lower extremity soft tissue sarcomas is function-sparing, limb-preserving resection and reconstruction with or without oncological therapy. The aim of this pilot study was to test the suitability and adequacy of the Finnish translations of two functional outcome questionnaires (Toronto Extremity Salvage Score and Musculoskeletal Tumor Society score) and to perform a preliminary investigation of functional outcomes of Finnish lower-limb soft tissue sarcoma patients after operative treatment. Materials and Methods: Between June 2015 and December 2015, consecutive surgically treated outpatients were asked to participate in the study. Demographic, clinical, surgical, and oncological outcome data were collected. Two functional outcome questionnaires were used (Toronto Extremity Salvage Score and Musculoskeletal Tumor Society scores). A comparative analysis is presented. Results: A total of 19 lower-limb soft tissue sarcoma patients with a mean follow-up time of 2 years and 10 months were included. All (n = 19) invited patients participated in the study. Mean age was 62.3 years. In total, 13 had high-grade sarcomas. Eight wounds were closed directly, four used skin grafts, and five required flap reconstructions. One patient required a tumor prosthesis, and one required a rotationplasty. A total of 14 patients received oncological therapy. No problems or difficulties were reported in using and completing the Finnish versions of the Toronto Extremity Salvage Score or Musculoskeletal Tumor Society questionnaires. The overall Toronto Extremity Salvage Score and Musculoskeletal Tumor Society scores were 88 and 76, respectively. Conclusion: This pilot study suggests that the Finnish versions of the Toronto Extremity Salvage Score and Musculoskeletal Tumor Society questionnaires are suitable for measuring functional outcome after lower extremity soft tissue sarcomas treatment. Functional outcomes vary from moderate to excellent.

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Cross-cultural adaptation and validation of the Chinese version of Toronto Extremity Salvage Score for patients with extremity sarcoma

SpringerPlus ◽

10.1186/s40064-016-2818-9 ◽

2016 ◽

Vol 5 (1) ◽

Cited By ~ 4

Author(s):

Leilei Xu ◽

Minghui Sun ◽

Weixiang Sun ◽

Xiaodong Qin ◽

Zezhang Zhu ◽

...

Keyword(s):

Cultural Adaptation ◽

Cross Cultural ◽

Chinese Version ◽

Cross Cultural Adaptation ◽

Extremity Sarcoma ◽

Toronto Extremity Salvage Score ◽

Extremity Salvage

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Further validation of the Toronto extremity salvage score for lower extremity soft tissue sarcoma based on Finnish patients

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2020.08.007 ◽

2020 ◽

Author(s):

Gilber Kask ◽

Mikko M. Uimonen ◽

Ian Barner-Rasmussen ◽

Erkki J. Tukiainen ◽

Carl Blomqvist ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Lower Extremity ◽

Extremity Soft Tissue Sarcoma ◽

Toronto Extremity Salvage Score ◽

Extremity Salvage

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Validation of the SF-6D Health State Utilities Measure in Lower Extremity Sarcoma

Sarcoma ◽

10.1155/2014/450902 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 6

Author(s):

Kenneth R. Gundle ◽

Amy M. Cizik ◽

Stephanie E. W. Punt ◽

Ernest U. Conrad ◽

Darin J. Davidson

Keyword(s):

Lower Extremity ◽

Convergent Validity ◽

Short Form ◽

Health State ◽

Cross Sectional ◽

Extremity Sarcoma ◽

Sf 36 ◽

Toronto Extremity Salvage Score ◽

Patient Reported ◽

Health State Utilities

Aim. Health state utilities measures are preference-weighted patient-reported outcome (PRO) instruments that facilitate comparative effectiveness research. One such measure, the SF-6D, is generated from the Short Form 36 (SF-36). This report describes a psychometric evaluation of the SF-6D in a cross-sectional population of lower extremity sarcoma patients.Methods. Patients with lower extremity sarcoma from a prospective database who had completed the SF-36 and Toronto Extremity Salvage Score (TESS) were eligible for inclusion. Computed SF-6D health states were given preference weights based on a prior valuation. The primary outcome was correlation between the SF-6D and TESS.Results. In 63 pairs of surveys in a lower extremity sarcoma population, the mean preference-weighted SF-6D score was 0.59 (95% CI 0.4–0.81). The distribution of SF-6D scores approximated a normal curve (skewness = 0.11). There was a positive correlation between the SF-6D and TESS (r=0.75,P<0.01). Respondents who reported walking aid use had lower SF-6D scores (0.53 versus 0.61,P=0.03). Five respondents underwent amputation, with lower SF-6D scores that approached significance (0.48 versus 0.6,P=0.06).Conclusions. The SF-6D health state utilities measure demonstrated convergent validity without evidence of ceiling or floor effects. The SF-6D is a health state utilities measure suitable for further research in sarcoma patients.

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Assessment of Objective Ambulation in Lower Extremity Sarcoma Patients with a Continuous Activity Monitor: Rationale and Validation

Sarcoma ◽

10.1155/2014/947082 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Kenneth R. Gundle ◽

Stephanie E. Punt ◽

Ernest U. Conrad III

Keyword(s):

Lower Extremity ◽

Limb Salvage ◽

Objective Assessment ◽

Objective Measure ◽

Patient Reported Outcome Measures ◽

Activity Monitor ◽

Cross Sectional ◽

Extremity Sarcoma ◽

Toronto Extremity Salvage Score ◽

Patient Reported

In addition to patient reported outcome measures, accelerometers may provide useful information on the outcome of sarcoma patients treated with limb salvage. The StepWatch (SW) Activity Monitor (SAM) is a two-dimensional accelerometer worn on the ankle that records an objective measure of walking performance. The purpose of this study was to validate the SW in a cross-sectional population of adult patients with lower extremity sarcoma treated with limb salvage. The main outcome was correlation of total steps with the Toronto Extremity Salvage Score (TESS). In a sample of 29 patients, a mean of 12 days of SW data was collected per patient (range 6–16), with 2767 average total steps (S.D. 1867; range 406–7437). There was a moderate positive correlation between total steps and TESS(r=0.56, P=0.002). Patients with osseous tumors walked significantly less than those with soft tissue sarcoma (1882 versus 3715,P<0.01). This study supports the validity of the SAM as an activity monitor for the objective assessment of real world physical function in sarcoma patients.

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