2001 CTOS Annual Meeting Posters— Radiation Oncology

A COMPARISON OF LOWER EXTREMITY FUNCTIONAL OUTCOME FOLLOWING LIMB PERFUSION, PRE- OR POST-OPERATIVE RADIOTHERAPY FOR SOFT TISSUE SARCOMA
Peter Hohenberger¹,  Jay Wunder²,  Anja Herrmann¹,  Anthony Griffin²,  Robert Bell²,  Brian O'Sullivan³,  Charles Catton³,  Aileen Davis^4
1Robert-Roessle Hospital and Tumor Institute at the Max-Debruck Center for Molecular Medicine,  ²Mount Sinai Hospital,  ³Princess Margaret Hospital,  ⁴Toronto Rehabilitation Institute

METHODS: 29 patients in each of the three treatment groups were matched for age, anatomical tumour site, tumour size and months of functional follow-up. Baseline sample characteristics (age, gender, primary vs. recurrent tumour) and variables known to impact on functional outcome (motor nerve sacrifice, bone resection, complications, vascular reconstruction) were compared to ensure group similarity. The primary outcome, the Toronto Extremity Salvage Score (TESS), was evaluated among the three groups using a paired t-test and then regression analysis.

RESULTS: There were no significant differences among the groups on any of age (group mean range 44 to 47), tumour size, anatomical location, months of functional follow-up (group mean range 21 to 23 mos). Although not significantly different, 11 of the ILP group presented with recurrent tumour as compared to 3 in the preop and 2 in the postop groups. There were no statistically significant differences in the number of cases with bone, major motor nerve, or vessel resection or in wound complications in the three groups. The ILP group had a lower TESS score than the postop rads group (p=0.005); TESS means of 80.8 vs. 91.5 vs. 85.6 for the ILP, preop and postop groups respectively. In a model evaluating gender and treatment group, gender was a significant predictor of the TESS (men mean of 87.1 vs women mean of 75.7, p=0.005) but treatment group was not significant (p=0.144). Use of pain medication was the same in all groups (6, 6 and 5 cases) but 5 in the ILP group used an ambulatory aids as compared to 2 and 1 in the preop and postop rads groups. At last follow-up 4 ILP patients and 1 postop case had developed local recurrence. 9 of the ILP, 6 of the preop and 4 of the postop group had metastatic disease.

CONCLUSION: STS patients undergoing ILP, preop or postop radiotherapy report relatively high levels of function with the least disability reported in the preop radiotherapy group. In these data, women have lower scores than men, particularly in the ILP treatment group.