What does this research mean for the field?

Standard health-related quality of life measures, specifically the EORTC QLQ-C30 and TESS, fail to account for contextual factors such as prosthesis and assistive device use in sarcoma patients post-amputation, leading to inconsistent and inaccurate scoring of physical functioning. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The research aims to understand the issues in measuring physical functioning in patients with extremity/pelvic sarcoma after amputation.

April 7, 2026Annals of Surgical Oncology1 citationsOpen Access

Understanding Physical Functioning in Patients with Sarcoma After Amputation: Using an International Classification of Functioning, Disability and Health (ICF) Approach

TBTom I. BootsmaErasmus MC DHDide den HollanderRadboud University Nijmegen MRMilou J. P. ReuversErasmus MC

Key Points

The research aims to understand the issues in measuring physical functioning in patients with extremity/pelvic sarcoma after amputation.
Conducted semistructured interviews with 20 patients from Dutch sarcoma centers.
Explored experiences of physical functioning using health-related quality of life measures.
Performed thematic analysis to organize data into ICF framework themes.
Amputation affects five interrelated International Classification of Functioning domains.
Patients reported challenges with sensory functions, pain, and movement.
Limitations identified in self-care, mobility, and social participation.
Environmental factors, including support and technology, significantly influence physical functioning.

Abstract

Abstract Background Physical functioning (PF) is significantly affected following amputation for extremity/pelvic sarcomas. Commonly used health-related quality of life (HRQoL) measures such as the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) (C30) and the Toronto Extremity Salvage Score (TESS) have not been validated in this population. This study examines the challenges of measuring PF in patients with extremity/pelvic sarcoma after amputation. It explores how these patients interpret the TESS and C30, particularly regarding prosthesis and assistive device use. PF is considered within the International Classification of Functioning, Disability and Health (ICF) framework. Patients and Methods We conducted semistructured interviews with 20 patients who had undergone amputation for extremity/pelvic sarcoma, recruited from three Dutch sarcoma centers. Interviews explored patients’ experiences of PF using the C30 and TESS. Thematic analysis was conducted, with data organized into key themes and subthemes within the ICF framework. Results Amputation impacts five interrelated ICF domains: body functions and structures, activity and participation, and environmental factors. Within body functions and structures, patients reported challenges related to sensory functions and pain, movement functions, and genital and reproductive health. In the domain of activity and participation, limitations were noted in general tasks and demands, mobility, self-care, domestic life, and community, social, and civic life. Environmental factors such as products and technology and social support also played a role. Conclusions A tailored measurement strategy is needed for patients with sarcoma post-amputation. Importantly, neither the C30 nor the TESS explicitly accounts for these contextual factors, which can lead to inconsistent or inaccurate scoring of physical functioning in this population.

Ask AI

Helpful

Bookmark

View Full Paper