Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, HUS, Helsinki, Finland.
Department of Orthopaedics and Traumatology, Unit of Musculoskeletal Surgery, Tampere University Hospital, Tampere, Finland.
Ann Surg Oncol. 2019 Dec;26(13):4707-4722. doi: 10.1245/s10434-019-07698-w. Epub 2019 Aug 12.
The importance of functional outcome (FO) in the treatment of patients with extremity soft tissue sarcoma (STS) has been increasingly recognized in the last three decades. This systematic review aimed to investigate how FO is measured in surgically treated lower-extremity STS patients.
A systematic search of PubMed, Web of Science, and Scopus was performed based on the PRISMA guidelines. The methodologic quality of the publications was measured using the MINORS tool. The results from the included studies examining measurement types, measures, and time of FO measurement were compiled. The FO pooled mean and standard deviation were calculated as a weighted average for the groups. The validity of the applied measures is reported.
The literature search found 3461 publications, 37 of which met the inclusion criteria. The measurement types used were clinician-reported outcomes (n = 27), patient-reported outcomes (n = 20), and observer-reported outcomes (n = 2). The most frequently used measures were the Toronto Extremity Salvage Score (TESS) (n = 16) and the Musculoskeletal Tumor Society (MSTS) score 1993 (n = 12). The postoperative FO was relatively good. The pooled mean TESS and MSTS 1993 scores were respectively 83.3 and 86.2 (out of 100). Of the 10 previously reported measures, 3 provide validated FO scores. The methodologic quality of publications was generally low.
Based on this systematic review, several different methods exist for assessing FO in patients with lower-extremity sarcoma. The most frequently used measure is a validated TESS. The postoperative FO of patients with lower-extremity STS seems to increase to the preoperative baseline level during long-term follow-up evaluation.
在过去三十年中，功能结果（FO）在治疗肢体软组织肉瘤（STS）患者中的重要性日益得到认可。本系统评价旨在研究如何在接受手术治疗的下肢 STS 患者中测量 FO。
根据 PRISMA 指南，对 PubMed、Web of Science 和 Scopus 进行系统检索。使用 MINORS 工具测量出版物的方法学质量。编译了纳入研究中检查 FO 测量类型、测量方法和 FO 测量时间的结果。计算了 FO 汇总平均值和标准差作为组的加权平均值。报告了应用措施的有效性。
文献检索发现 3461 篇出版物，其中 37 篇符合纳入标准。使用的测量类型包括临床医生报告的结果（n=27）、患者报告的结果（n=20）和观察者报告的结果（n=2）。最常使用的测量方法是多伦多肢体挽救评分（TESS）（n=16）和肌肉骨骼肿瘤学会（MSTS）评分 1993 年（n=12）。术后 FO 相对较好。汇总的平均 TESS 和 MSTS 1993 评分分别为 83.3 和 86.2（满分 100）。在之前报告的 10 项措施中，有 3 项提供了经过验证的 FO 评分。出版物的方法学质量普遍较低。
根据本系统评价，有几种不同的方法可用于评估下肢肉瘤患者的 FO。最常用的测量方法是经过验证的 TESS。下肢 STS 患者的术后 FO 在长期随访评估中似乎会增加到术前基线水平。
