Department of Plastic Surgery, Helsinki University Hospital, University of Helsinki, P.O. Box 266, FI-00029 HUS, Finland.
Department of Orthopedics and Traumatology, Helsinki University Hospital and University of Helsinki, P.O. Box 266, FI-00029 HUS, Finland.
J Plast Reconstr Aesthet Surg. 2022 May;75(5):1543-1550. doi: 10.1016/j.bjps.2021.11.081. Epub 2021 Dec 1.
Interest in functional outcome (FO) and health-related quality of life (HRQL) in extremity soft-tissue sarcoma (STS) patients has increased. The aim of this study was to validate two FO questionnaires for upper extremity STS patients: the Toronto Extremity Salvage Score (TESS) and short version of the Disability of Arm, Shoulder and Hand (QuickDASH), based on Finnish population data. A multi-center study was conducted at two academic sarcoma centers. Surgically treated upper extremity STS patients were invited to participate. Patients completed the TESS and the QuickDASH with HRQL questionnaires the 15D and the QLQ-C30. The scores were analyzed and compared. Fifty-five patients with a mean follow-up period of 4.7 years were included. Mean age was 63 years (standard deviation [SD] 14.6). The mean score for TESS was 88.5 (SD 15.1) and for QuickDASH 17.8 (SD 19.6). The QuickDASH had a statistically significantly better score coverage. A ceiling effect was noted, 27% and 20% for TESS and QuickDASH, respectively. The TESS and QuickDASH scores were strongly correlated (r= -0.89). The TESS score strongly correlated with the QLQ-C30 (r = 0.79) and the 15D score (r = 0.70). The QuickDASH score correlated strongly with the QLQ-C30 score (r=-0.71) and moderately with the 15D score (r= -0.56). The TESS score had a statistically significantly stronger correlation with the 15D score than QuickDASH (p<0.005). Both the TESS and the QuickDASH provide reliable scores for assessing FO in upper extremity STS patients. The QuickDASH has a better coverage, whereas TESS showed a stronger correlation to HRQL scores.
人们对上肢软组织肉瘤（STS）患者的功能结果（FO）和健康相关生活质量（HRQL）的兴趣日益增加。本研究旨在基于芬兰人群数据，验证用于上肢 STS 患者的两种 FO 问卷：多伦多上肢挽救评分（TESS）和手臂、肩部和手部残疾问卷的简短版（QuickDASH）。在两个学术肉瘤中心进行了一项多中心研究。邀请接受手术治疗的上肢 STS 患者参与。患者完成了 TESS 和 QuickDASH 问卷，同时还完成了 HRQL 问卷 15D 和 QLQ-C30。对这些评分进行了分析和比较。共纳入 55 例患者，平均随访时间为 4.7 年。患者平均年龄为 63 岁（标准差 [SD] 14.6）。TESS 的平均评分为 88.5（SD 15.1），QuickDASH 的平均评分为 17.8（SD 19.6）。QuickDASH 的评分覆盖范围具有统计学意义上的优势。TESS 和 QuickDASH 分别有 27%和 20%的天花板效应。TESS 和 QuickDASH 评分呈强相关（r=-0.89）。TESS 评分与 QLQ-C30 （r=0.79）和 15D 评分（r=0.70）呈强相关。QuickDASH 评分与 QLQ-C30 评分呈强相关（r=-0.71），与 15D 评分呈中度相关（r=-0.56）。TESS 评分与 15D 评分的相关性明显强于 QuickDASH（p<0.005）。TESS 和 QuickDASH 均可为上肢 STS 患者的 FO 评估提供可靠的评分。QuickDASH 的覆盖范围更好，而 TESS 与 HRQL 评分的相关性更强。
