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Koenis MJJ, Dijkstra PU, Postema SG, Janssen WGM, Brouwers MAH, van der Sluis CK. Musculoskeletal complaints and disability in a group of young adults with major congenital upper limb differences in The Netherlands. Disabil Rehabil 2023:1-10. [PMID: 37947091 DOI: 10.1080/09638288.2023.2278165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE To determine prevalence of musculoskeletal complaints (MSCs) in adults with major congenital upper limb differences (CoULD) compared to able-bodied controls, and to examine associations of MSCs and disability with various biopsychosocial factors. MATERIALS AND METHODS Questionnaire-based cross-sectional study assessing MSCs, disability (using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH)), general and mental health status, physical work demands, and upper extremity range of motion. RESULTS Seventy-one individuals with CoULD (participation rate: 41%) and 71 controls matched on age, gender, and education were included (49% female, mean age 28.9 years). Year prevalence of MSCs was significantly higher in the CoULD group (35%) than in the control group (18%). The CoULD group was less often employed and had lower scores on all measures of upper limb range of motion and hand grip. MSCs were associated with higher DASH scores and higher reported work demands. Disability was associated with female gender, more joints with limited range of motion, unemployment, and lower general and mental health. Factors associated with disability did not differ between groups. CONCLUSIONS MSCs are a frequent problem in young adults with major CoULD. To prevent or reduce MSC and disability, clinicians and researchers should be aware of the associated factors. Implications for rehabilitationThe year prevalence of musculoskeletal complaints (MSCs) in those with major congenital upper limb differences (CoULD) was approximately double to that of the control group, implying a potential relationship between CoULD and MSCs.Rehabilitation professionals should develop personalized strategies to manage work demands in those with CoULD, considering the association between MSCs and higher reported work demands.Recognizing the impact of a negatively perceived body image on mental health, clinicians should integrate psychological counseling into rehabilitation treatments to support mental well-being and improve overall quality of life in those with CoULD.Rehabilitation professionals should educate individuals with CoULD about the potential associations between upper limb work demands, MSCs, and disability.
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Affiliation(s)
- Martinus J J Koenis
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Pieter U Dijkstra
- Department of Rehabilitation Medicine and, Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sietke G Postema
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Wim G M Janssen
- Department of Rehabilitation Medicine Erasmus MC, Rijndam Rehabilitation Center Rotterdam, Rotterdam, The Netherlands
| | | | - Corry K van der Sluis
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Nakata E, Fujiwara T, Kunisada T, Nakahara R, Katayama H, Itano T, Ozaki T. Results of resection of forearm soft tissue sarcoma. J Orthop Surg Res 2023; 18:599. [PMID: 37580775 PMCID: PMC10424346 DOI: 10.1186/s13018-023-04088-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023] Open
Abstract
PURPOSE Soft tissue sarcomas (STS) of the forearm are rare. We aim to assess their oncological and functional outcomes. METHODS We retrospectively evaluated 34 patients who underwent surgical excision for forearm STS at our institution between 1993 and 2020. We analyzed postoperative Musculoskeletal Tumor Society rating scale (MSTS) and local recurrence-free survival (LRFS), metastasis-free survival, and overall survival (OS) rates. The significance of the following variables was determined: age, sex, histology, tumor size, Fédération Nationale des Centres de Lutte contre le Cancer grade, American Joint Committee on Cancer stage, surgical margin, unplanned excision, metastases upon initial presentation, receipt of chemotherapy, and radiotherapy (RT). RESULTS The postoperative median MSTS score was 28. Bone resection or major nerve palsy was the only factor that influenced MSTS scores. The median MSTS scores in patients with or without bone resection or major nerve palsy were 24 and 29, respectively (P < 0.001). The 5-year LRFS rates was 87%. Univariate analysis revealed that the histological diagnosis of myxofibrosarcoma was the only factor that influenced LRFS (P = 0.047). The 5-year MFS rates was 71%. In univariate analysis, no factors were associated with MFS. The 5-year OS rates was 79%. Age was the only factor that influenced OS (P = 0.01). CONCLUSION In the treatment of forearm STS, reconstruction of the skin and tendon can compensate for function, while bone resection and major nerve disturbance cannot. Careful follow-up is important, especially in patients with myxofibrosarcoma, due to its likelihood of local recurrence.
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Affiliation(s)
- Eiji Nakata
- Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Okayama City, Okayama, 700-8558, Japan.
| | - Tomohiro Fujiwara
- Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Okayama City, Okayama, 700-8558, Japan
| | - Toshiyuki Kunisada
- Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Okayama City, Okayama, 700-8558, Japan
| | - Ryuichi Nakahara
- Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Okayama City, Okayama, 700-8558, Japan
| | - Haruyoshi Katayama
- Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Okayama City, Okayama, 700-8558, Japan
| | - Takuto Itano
- Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Okayama City, Okayama, 700-8558, Japan
| | - Toshifumi Ozaki
- Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Okayama City, Okayama, 700-8558, Japan
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Ballatori AM, Shahrestani S, Ton A, Chen XT, Yamout T, Gettleman BS, Heckmann ND, Menendez LR, Christ AB. Postoperative Complication and Reoperation Rates Following Resection of Soft Tissue vs. Bone Malignancies Based on Anatomic Location in the Inpatient Setting. Sarcoma 2023; 2023:5455719. [PMID: 36937506 PMCID: PMC10023224 DOI: 10.1155/2023/5455719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/20/2023] [Accepted: 02/25/2023] [Indexed: 03/17/2023] Open
Abstract
Introduction Surgical excisions of upper and lower extremity malignancies are increasing annually, due in part to the rising incidence of sarcomas. The purpose of this study is to compare readmissions, reoperation rate, and complications following surgical excision of soft/connective tissue vs bone malignancies of the upper and lower extremities. Methods The Nationwide Readmissions Database (NRD) was queried from 2016-2017 to conduct a retrospective analysis of 16,435 patients diagnosed with malignant neoplasms of the long bone (ULLB, n = 1,433) and soft tissue (ULST, n = 2,049) of the upper limb and malignant neoplasms of the long bone (LLLB, n = 5,422) and soft tissue (LLST, n = 7,531) of the lower limb. Patients who underwent surgical excision of their neoplasms were included. Binomial multivariate logistic regression was used to compare complications, nonelective readmission rates, and reoperation rates between the two groups at 30 and 90 days. Results Average age of the ULST group was 61.88, with 36% female. Average age of the ULLB group was 44.97, with 41.90% female. Average age of the LLST group was 60.96, with 46.90% female. Average age of the LLLB group was 43.09, with 42.60% female. The ULST group had lower odds of readmission within 30 days (p=0.263), which became significant within 90 days of surgery (p=0.045). The LLST group had significantly higher odds of infection, reoperation within 30 to 90 days of the index surgery compared to the LLLB group (p < 0.0001). The LLST group had significantly lower odds of readmission within 30 (p=0.04) and 90 days (p=0.015) of the index surgery. Conclusion Patients in the ULST group had significantly lower odds of 90-day readmission compared to the ULLB group. There were also significantly lower odds of 30- and 90-day readmission in the LLST group compared to the LLLB group. However, the LLST group had significantly higher odds of infection and reoperation within 30 and 90 days compared to the LLLB group.
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Affiliation(s)
- Alexander M. Ballatori
- 1Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Shane Shahrestani
- 1Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Andy Ton
- 1Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Xiao T. Chen
- 1Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Tarek Yamout
- 2Virginia Spine Institute, Reston, Virginia, USA
| | | | - Nathanael D. Heckmann
- 1Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Lawrence R. Menendez
- 1Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Alexander B. Christ
- 1Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California, USA
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Clinical Outcomes of Soft Tissue Sarcoma around the Elbow Joint: A Retrospective Single Institution Study. Sarcoma 2022; 2022:1087726. [PMID: 36573098 PMCID: PMC9789912 DOI: 10.1155/2022/1087726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Background We report a retrospective case series analysis of clinical outcomes of patients with soft tissue sarcoma around the elbow. Methods Twenty-two patients underwent surgical tumor excision between January 1999 and May 2017, with a mean follow-up of 85.2 months. Results Six tumors were localized in the upper arm, nine in the elbow, and seven in the forearm. Sixteen tumors were deep-seated, and six were superficially located. Fifteen patients underwent wide excision, including one amputation, and 18 achieved (81.8%) negative margins histologically. Two local recurrences and four distant metastases developed. The mean Musculoskeletal Tumor Society score was 92.0% (range, 33.3-100). The 5-year local recurrence-free survival rate, metastasis-free survival rate, and overall survival rate were 90.0%, 77.0%, and 79.7%, respectively. Conclusions Local control and limb function can have favorable outcomes when the tumor excised has a histologically negative margin without sacrificing the major structure.
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Moon TM, Furdock R, Rhea L, Pergolotti M, Cipriano C, Spraker MB. PROMIS scores of patients undergoing neoadjuvant and adjuvant radiation therapy for surgically excised soft tissue sarcoma. Clin Transl Radiat Oncol 2021; 31:42-49. [PMID: 34622039 PMCID: PMC8479243 DOI: 10.1016/j.ctro.2021.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/10/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
First to evaluate PROMIS for patients undergoing radiotherapy and surgery for sarcoma. Patients exhibited meaningful change in PROMIS scores throughout the treatment. Analyses show PROMIS scores were similar between pre- and post-operative radiotherapy. Wound complications were associated with increases in anxiety and decreases in function. These data should be considered when selecting ideal therapy.
Introduction Few recent studies have examined patient reported outcomes (PROs) during pre- or post-operative radiation therapy (RT) for soft tissue sarcoma (STS), and none have used PROMIS. This study aims to examine PROMIS scores across peri-operative time points for patients receiving pre- or post-operative RT. Methods Anxiety, depression, pain interference, and physical function PROMIS domains were collected at the pre-operative (1), immediate post-operative (2), and post-treatment completion (3) timepoints for patients undergoing surgery and either pre-operative or post-operative RT. Median scores were compared between groups using the Kruskal-Wallis test. The reliable change index was used to determine minimum important change in PROMIS scores and to compare scores between timepoints. Results 95 patients were included (19 pre-operative, 76 post-operative). Both groups had significant decreases in function during treatment. Patients with wound complications were more likely to have significant increases in anxiety (36.4% vs. 8.3%; p = 0.020) and decreases in physical function (57.1% vs. 16.2%; p = 0.011) independent of RT timing. Conclusions This study demonstrates minimum significant change thresholds to detect PROMIS changes in STS patients undergoing pre- and post-operative radiotherapy. As expected, more patients with pre-operative RT than post-operative RT had wound complications (p = 0.06), but patients with complications in both groups had worse anxiety and function at the completion of treatment compared with those that did not. The association of wound complications with worse anxiety and physical function at completion of treatment should be considered when making individualized treatment recommendations regarding the timing of RT.
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Affiliation(s)
- T M Moon
- Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - R Furdock
- Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - L Rhea
- Division of Biostatistics, Washington University in St. Louis, St. Louis, MO, United States
| | - M Pergolotti
- ReVital Cancer Rehabilitation Program, Select Medical, Mechanicsburg, PA, United States.,Department of Occupational Therapy, University of North Carolina in Chapel Hill, Chapel Hill, NC, United States
| | - C Cipriano
- Department of Orthopedic Surgery, Washington University in St. Louis, St. Louis, MO, United States
| | - M B Spraker
- Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO, United States
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Annovazzi A, Rea S, Zoccali C, Sciuto R, Baldi J, Anelli V, Petrongari MG, Pescarmona E, Biagini R, Ferraresi V. Diagnostic and Clinical Impact of 18F-FDG PET/CT in Staging and Restaging Soft-Tissue Sarcomas of the Extremities and Trunk: Mono-Institutional Retrospective Study of a Sarcoma Referral Center. J Clin Med 2020; 9:jcm9082549. [PMID: 32781683 PMCID: PMC7463806 DOI: 10.3390/jcm9082549] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Soft-tissue sarcomas (STS) represent a wide heterogeneous class of rare tumors. The exact role 18F-fluorodeoxyglucose positron emission/computed tomography (18F-FDG PET/CT) in the evaluation of STS is not well established. The aim of the present study was to evaluate how the use of 18F-FDG PET/CT in STS could influence patient therapy planning, looking for a possible added value over computed tomography and magnetic resonance imaging—the most used modalities in the study of STS. Differences in SUVmax according to histologic subtype and tumor grade were also considered. Methods: a total of 345 consecutive 18F-FDG PET/CT scans performed for initial staging (n = 171) or for suspected disease relapse (n = 174) in 282 patients with STS extracted from the local Information System database were retrospectively reviewed. Results: 18F-FDG PET/CT altered therapy planning in 80 cases (16.4% for staging and 29.9% in restaging), both for disease upstaging (58.8%) and downstaging (41.2%) Conclusions: 18F-FDG PET/CT could significantly influence management of patients with STS, particularly for restaging.
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Affiliation(s)
- Alessio Annovazzi
- Nuclear Medicine Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.R.); (R.S.)
- Correspondence:
| | - Sandra Rea
- Nuclear Medicine Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.R.); (R.S.)
| | - Carmine Zoccali
- Oncological Orthopaedics Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.Z.); (J.B.); (R.B.)
| | - Rosa Sciuto
- Nuclear Medicine Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (S.R.); (R.S.)
| | - Jacopo Baldi
- Oncological Orthopaedics Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.Z.); (J.B.); (R.B.)
| | - Vincenzo Anelli
- Radiology and Diagnostic Imaging Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Maria G. Petrongari
- Department of Radiation Oncology, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Edoardo Pescarmona
- Clinical Pathology, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.Z.); (J.B.); (R.B.)
| | - Virginia Ferraresi
- Medical Oncology 1, IRCCS—Regina Elena National Cancer Institute, 00144 Rome, Italy;
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Jami SA, Mobarak SA, Jiandang S, Xi Z, Tanvir MMS, Monilal SS. Clinical and strategic outcomes of metastatic synovial sarcoma on limb. Int J Health Sci (Qassim) 2020; 14:38-43. [PMID: 33192230 PMCID: PMC7644453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Synovial sarcoma (SS) is one of the most frequent malignant soft-tissue tumors, and nearly 65% arise in the lower extremities. Survival prediction and the risk factors of the patients are poorly understood. Thus, this study examined the survival and prognostic variables of metastatic limb SS (LSS). METHODS Clinical data of LSS patients with metastasis at the presentation from 1975 to 2017 were obtained from the Surveillance, Epidemiology, and End Results database program database. Kaplan-Meier method was used to describe the survival curves. Univariate and multivariate Cox regression analysis were conducted to reveal the real prognostic predictors. RESULTS Male predominance was observed in the metastatic LSS group from a total number of 217 patients. This population was composed of 49.8% not other specified subtype, 32.7% spindle cell subtype, 17.1% biphasic subtype, and 0.5% epithelioid cell subtype. The 3-year overall survival (OS) and cancer-specific survival (CSS) rates of the entire group were 27.2% and 28.3%, respectively. Tumor size <10 cm, surgery, radiotherapy, and chemotherapy were calculated as independent predictors of improved OS and CSS by multivariate analyses. CONCLUSION SS is still a disease with a poor prognosis. This can increase the survival rate and time by the well-planned treatment.
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Affiliation(s)
- Sayed Abdulla Jami
- Department of Spinal Surgery, General Hospital of Ningxia Medical University, Ningxia Medical University 804 Shengli, Xingqing, Yinchuan, 750004, Ningxia, People’s Republic of China
| | - Siam Al Mobarak
- Department of Cardiology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People’s Republic of China
| | - Shi Jiandang
- Department of Spinal Surgery, General Hospital of Ningxia Medical University, Ningxia Medical University 804 Shengli, Xingqing, Yinchuan, 750004, Ningxia, People’s Republic of China,
Address for correspondence: Shi Jiandang, Department of Spinal Surgery, General Hospital of Ningxia Medical University, Ningxia Medical University, 804 Shengli, Xingqing, Yinchuan, 750004, Ningxia, People’s Republic of China. E-mail:
| | - Zhu Xi
- Department of Spinal Surgery, General Hospital of Ningxia Medical University, Ningxia Medical University 804 Shengli, Xingqing, Yinchuan, 750004, Ningxia, People’s Republic of China
| | - M M Sohel Tanvir
- Department of Spinal Surgery, General Hospital of Ningxia Medical University, Ningxia Medical University 804 Shengli, Xingqing, Yinchuan, 750004, Ningxia, People’s Republic of China
| | - Sonjoy Sutradhar Monilal
- Department of Cardiology, Southern Medical University, 1838 Shatai North Street, Baiyun District, Guangzhou, 510515, Guangdong Province, People’s Republic of China
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