Materials and Methods
Overview and Eligibility Criteria for Review
Search Methods
Study Data
Validity Assessment
Functional Outcome
Quality of Publications Assessment
Results
Study Selection
Study Characteristics
Author | Year | Country | Study type | Patients | Tumor location | Number of patients | Age (years)a | Measure | Measurement type | Measurement time points | MINORS score |
---|---|---|---|---|---|---|---|---|---|---|---|
Slump et al.18 | 2018 | NET/CAN | Re, C | STS, free or pedicled flap reconstruction | LE; UE | 266. LE 181 | 59.2 ± 18.6 | TESS, MSTS 1987, 1993 | PRO, ClinRO | Pre- and postoperatively at 9–12 months | 75 |
Podleska et al.16 | 2017 | GER | Re, CS | STS, previously nonresectable sarcoma, chemotherapy | LE | 27 | 52.7 (12–73) | SMFA-D | PRO | Minimum 5 months after surgery | 69 |
Stoeckle et al.17 | 2017 | F | Re, CS | STS, primary operated non-metastatic STS | LE | 728, LE 480 | Median 59 (16–91) | Own | ClinRO | N/P | 44 |
Saebye et al.19 | 2017 | DEN | Re, CS | STS, treated with first-time limb-sparing surgery without bone resection | LE; UE | 128, LE 90 | Median 61 (IQR 47–70) | TESS, MSTS 1993 | PRO, ClinRO | Minimum 1 year after surgery | 75 |
Harati20 | 2016 | GER | Re; CS | STS, extending distally to the level of the knee joints | LE | 120 | 57.4 (17–89) | TESS, FF I, SF–36 | PRO | Minimum 1.3 years after surgery | 50 |
Heaver et al.21 | 2016 | UK | Re, CS | BTS/STS/other tumors, patients underwent limb-salvage surgery | LE; UE | 198, LE 152 | LE: 52.5 (14–86) | TESS | PRO | Minimum 3 months after surgery | 38 |
Chang et al.22 | 2016 | USA | Re, CS | All tumor types, 77 muscle only flaps, 67 MC flaps and 76 FC flaps | LE;UE | 220. LE 156 | LE: 49.5 ± 18.1 | MSTS 1993, Karnof-sky score | ClinRO | N/P | 71 |
Furtado et al.23 | 2015 | UK | Re, CS | BTS/STS, primary tumor, management by primary or secondary amputation | LE | 100, LE STS 37 | 53.6 (19–91) | TESS | PRO | Minimum 1 year after surgery | 56 |
Rivard et al.24 | 2015 | CAN | Pr, C | STS, primary or recurrent sarcoma | LE;UE; T | 52, LE 35 | 57 (24–83) | TESS, MSTS 1993, SF–36 | PRO, ClinRO | Preoperatively and at 6 and 12 months postoperatively | 92 |
Kang et al.25 | 2014 | S-K | Re, CC | STS, flap reconstruction case-matched with primary wound-closure group | LE; UE | 148, LE 104 | 48.1 ± 19.3 | MSTS 1993 | ClinRO | 12–15 Months after surgery | 71 |
Townley et al.26 | 2013 | CAN | Re, C | BTS/STS, preoperatively irradiated compared with non-irradiated patients | 46, LE 24 | 57 ± 18 | TESS, MSTS 1987 | PRO, ClinRO | Minimum 1 year after surgery | 63 | |
Kozawa & Nishida27 | 2012 | JAP | Re, CS | BTS/STS, foot sarcoma. Limb salvage surgery or amputation | LE | 31, 24 STS | 43 (11–76) | ISOLS | ClinRO | Minimum 2 years after surgery | 56 |
Friedmann et al.28 | 2011 | CAN | Re, C | STS, limb salvage surgery with or without adjuvant external beam radiotherapy | LE; UE | 288. LE 207 | 53 (16–88) | MSTS 1993, TESS | PRO, ClinRO | Minimum 1 year after surgery | 63 |
Thacker et al.29 | 2008 | USA | Re, CS | STS, foot- and ankle-treated sarcoma patients | LE | 52 | 38 (11–96) | MSTS 1993 | ClinRO | Minimum 2 years after surgery | 63 |
Tsukushi et al.30 | 2008 | JAP | Re, CS | STS, investigation of results of arterial vs arteriovenous reconstruction | LE | 25 | 46 (18–77) | MSTS 1993 | ClinRO | Minimum 8 months after surgery | 71 |
Hoy et al.31 | 2006 | USA | Re, CS | BTS/STS/other, sarcoma resection, limb salvage and MFR | 102 MFR, STS 36 | 39 (4–90) | MSTS 1993 | ClinRO | Minimum 4 months after surgery | 50 | |
Pardasaney et al.32 | 2006 | USA | Re, CS | BTS/STS, amputations and limb salvage | LE | 408 | 49 (11–96) | Own | PRO, ObsRO | Minimum 2 years after surgery | 71 |
Pradhan et al.33 | 2006 | USA, CAN, UK | Re, CS | STS, treatment of the adductor compartment tumors, 3-center comparative study | LE | 184 | 56 (13–88) | TESS | PRO | N/P | 50 |
Nelson et al.34 | 2006 | USA | Re, CS | STS, wide resection, functional restoration surgery or soft-tissue coverage with flaps | LE; UE | 67, 48 LE | 52 (13–84) | TESS | PRO | N/P | 54 |
Thijssens et al.35 | 2006 | NET | Re, CS | STS, limb salvage vs amputation | LE;UE | O 39, LE 33 | Median 59 (15–78) | SF-36b | PRO | Minimum 1 year after surgery | 75 |
Davis et al.36 | 2005 | CAN | RCT | STS, surgery and pre- or postoperative radiotherapy. Function and radiation morbidity | LE; UE | 129, LE 100 | N/P | MSTS 1987, TESS | PRO, ClinRO | 2 Years | 88 |
Gerrand et al.37 | 2004 | CAN | Re, C | STS, limb-sparing surgery | LE | 207 | 54 (15–89) | MSTS 1993, TESS | PRO, ClinRO | Pre- and postoperatively within 1–2 years | 71 |
Rachbauer et al.38 | 2003 | AUS | Pr, CS | STS, marginal surgical resection, combined with both IOHDR and EBRT | LE; UP; T; R; HN | 39, LE 29 | Median 58 (17–87) | MSTS 1993 | ClinRO | Minimum 3 months after surgery | 69 |
O’Sullivan et al.52 | 2002 | CAN | RCT | STS, randomized by tumor size dichotomized at 10 cm. Pre- and postoperative radiotherapy groups. Wound healing | LE; UE | 182, LE 145 | 54.7 | MSTS 1987, TESS, SF-36 | PRO, ClinRO | Preoperatively and at 6 weeks and at 3, 6, 12 and 24 months postoperatively | 96 |
Davis et al.39 | 2002 | CAN | RCT | STS, randomized by tumor size dichotomized at 10 cm. Pre- and postoperative radiotherapy groups. Functional outcome | LE; UE | 185, LE 147 | 54.7 | MSTS 1987, TESS, SF-36 | PRO, ClinRO | Preoperatively and at 6 weeks and 3, 6, 12 and 24 months postoperatively | 96 |
Refaat et al.40 | 2002 | USA | Re, CS | BTS/STS, limb salvage or amputation | LE | 408 | 55 | Own | PRO, ObsRO | N/P | 67 |
Davis et al.41 | 2000 | CAN | Re, CS | STS, limb-preservation surgery | 172 | 51 | MSTS 1987, 1993, TESS, SF-36 | PRO, ClinRO | Minimum 1 year after surgery | 56 | |
Davis et al.42 | 1999 | CAN | Re, CC | STS/BTS, amputation matched with limb-sparing surgery | LE | 36 | 32 | TESS, SF-36, RNL | PRO | Minimum 1 year after surgery | 75 |
Colterjohn et al.43 | 1997 | CAN | Re, C | STS/fibromatosis, limb-salvage surgery for foot and ankle | LE | 30 | 51 | MSTS 1987 | ClinRO | See comment | 56 |
Pitcher & Thomas44 | 1994 | UK | Re, CS | STS, “functional compartmental resection” | LE | 24 | Median 47 (12–79) | Own | ClinRO | Minimum 1 month after surgery | 50 |
Keus et al.45 | 1994 | NET | Re, CS | STS, local treatment with curative intent and no known distant metastases | LE; UE | 156, LE 115 | Median 46 (4–89) | Own | ClinRO | N/P | 38 |
Moseley46 | 1992 | USA | Pr, C | STS, limb salvage using neoadjuvant chemotherapy, 2 groups | LE; UE | 38, LE 27 | Median 46/54c | Own | ClinRO | N/P | 79 |
Karasek et al.47 | 1992 | USA | Re, CS | STS/fibromatosis | LE; UE; T | 41, LE 25 | 50 (13–85) | Own | ClinRO | Minimum 7 months after surgery | 63 |
Robinson et al.48 | 1991 | UK | Re, CS | STS, treated with combination of surgery and radiotherapy; surgery alone; irradiation and intra-arterial doxorubicin | LE; UE; P | 54, LE 46 | 52 (23–82) | Own | ClinRO | Minimum 24 months after surgery | 31 |
Stinson et al.49 | 1991 | USA | Re, CS | STS, limb-sparing surgery, radiation therapy with or without adjuvant chemotherapy | LE; UE | 145 | N/P | Own | ClinRO | Minimum 1 year after surgery | 38 |
Talbert et al.50 | 1990 | USA | Re, CS | STS/unspecified, non-metastatic patients | LE; UE | 78, LE 39 | Age zones presented | Own | ClinRO | Minimum 28 months after surgery | 44 |
Lampert et al.51 | 1984 | USA | Re, CS | STS, wide local resection and radiation therapy | LE; UP; T; HN | 40, 20 LE STS | 37 (15–67) | Own, Convery scale | ClinRO | Minimum 7 months after surgery | 56 |
Type of Measurement to Assess FO
Measure | Measurement type | n | Studies | Valid | |||||
---|---|---|---|---|---|---|---|---|---|
R (n = 31) | P (n = 6) | CS (n = 25) | C (n = 7) | CC (n = 2) | RCT (n = 3) | ||||
TESS | PRO | 16 | 12 | 4 | 7 | 5 | 1 | 3 | + |
MSTS 1993 | ClinRO | 12 | 10 | 2 | 7 | 4 | 1 | 0 | + |
MSTS 1987 | ClinRO | 7 | 4 | 3 | 1 | 3 | 0 | 3 | + |
SF-36 | PRO | 7 | 5 | 2 | 3 | 1 | 1 | 2 | |
SMFA | PRO | 1 | 1 | 0 | 1 | 0 | 0 | 0 | |
FFI | PRO | 1 | 1 | 0 | 1 | 0 | 0 | 0 | |
Karnofsky score | ClinRO | 1 | 1 | 0 | 1 | 0 | 0 | 0 | |
Modified MSTS 1993 (ISOLS) | ClinRO | 1 | 1 | 0 | 1 | 0 | 0 | 0 | |
RNL | PRO | 1 | 1 | 0 | 0 | 0 | 1 | 0 | |
Convery scale | ClinRO | 1 | 1 | 0 | 1 | 0 | 0 | 0 |
FO Measures
Timing of FO Measurement
Validity of the Measures
Functional Outcome
Author | Year | LE patients (n) | Mean TESS (SD)a | Mean MSTS 1993 (SD)a | Mean MSTS 1987 (SD)b | Comments |
---|---|---|---|---|---|---|
Preoperative | ||||||
Rivard | 2015 | 35 | 79.8 (20.6) | 78.8 (20.7) | NA | FO results including UE STS patients (n = 15). Results available for MSTS from 45 and for TESS from 48 patients |
Gerrand | 2004 | 207 | 83.1 (20.1) | 87.9 (19.6) | NA | Results available for MSTS from 203 and for TESS from 172 patients |
Davis | 2002 | 147 | 84.4 (19.0) | NA | 26.8 (4.4) | FO results including UE STS patients (n = 38) |
Postoperative | ||||||
Saebye | 2017 | 90 | 94 (11.3) | 92.8 (13.6) | NA | FO results including UE STS patients (n = 38) |
Harati | 2016 | 120 | 63.8 (17.0) | NA | NA | FO results available for 30 patients |
Chang | 2016 | 129 | NA | 80.2 (NP) | NA | FO results including UE STS and other tumors. Excluded from the pooled mean and SD analysis due to missing SD data |
Furtado | 2015 | 37 | 56.4 (23.3) | NA | NA | TESS results including bone sarcoma patients (n = 63) |
Rivard | 2015 | 35 | 87.1 (16.6) | 88.8 (11.9) | NA | FO results including UE STS patients (n = 15). Results available for MSTS from 37 and for TESS from 41 patients |
Kang | 2014 | 104 | NA | 85.4 (13.9) | NA | FO result including UE STS patients (n = 44) |
Townley | 2013 | 21 | 84.76 (NP) | NA | 29.73 (NP) | FO results including bone sarcoma patients. Excluded from the pooled mean and SD analysis due to missing SD data |
Friedmann | 2011 | 204 | 89.4 (32.4–100)c | NA | 32 (11–35)c | FO results including UE STS patients (n = 59) |
Thacker | 2008 | 52 | NA | 83.3 (11.5) | NA | FO results available for 30 sarcoma patients |
Tsukushi | 2008 | 25 | NA | 70 (NP) | NA | |
Hoy | 2006 | 70 | NA | 90.3 (NP) | NA | FO results including UE STS (n = 6) and bone sarcoma (n = 39) patients |
Pradhan | 2006 | 184 | 77 (23–100)c | NA | NA | FO results available for 70 patients |
Nelson | 2006 | 48 | 85.1 (19.3) | NA | NA | FO results available for 34 patients |
Davis | 2005 | 100 | 83.2 (21.8) | NA | 28.9 (9.2) | FO results including UE STS patients (n = 29) |
Gerrand | 2004 | 207 | 82.7 (17.7) | 85.8 (19.0) | NA | Results available for MSTS from 189 and for TESS from 155 patients |
Rachbauer | 2003 | 29 | NA | 88.5 (NA) | NA | FO results including UE STS (n = 6) and other anatomic location sarcomas (n = 4) |
Davis | 2002 | 147 | 80.3 (21.1) | NA | 28.6 (7.8) | FO results including UE STS patients (n = 38). Results available for MSTS from 163 and for TESS from 156 patients |
Davis | 2000 | 172 | 82.7 (18.7) | 84.8 (20.4) | 30.0 (6.2) | |
Davis | 1999 | 29 | 81.6 (17.8) | NA | NA | FO results including bone sarcoma patients (n = 7) |
Colterjohn | 1997 | 29 | NA | NA | 31.4 (4.6) | FO results available for 26 patients |