Limb-Sparing Surgery May Offer Little Benefit to Cancer Patients

TUESDAY Aug. 11, 2009 -- Surgery that spares the limbs of some cancer patients may have little or no additional benefit over amputation in terms of health, cost or quality of life, researchers say.

Limb-sparing surgery can be just as effective as amputation in removing bone or soft-tissue sarcomas, but the analysis by Canadian researchers found few notable differences in psychological health and quality of life between people who had the two types of surgery. In fact, people who had their limbs saved tended to have more complications either shortly after the procedure or sometime later, the study found.

People who had limb-sparing surgery for cancers in the upper areas of the legs, including the hip, did reportedly have advantages over those who'd had amputation, but in general, saving the lower limbs did not necessarily ensure a better quality of life than amputation of all or part of the leg, the researchers found.

In terms of money, limb-sparing surgery has higher "up front" costs and rehabilitation costs, but making, maintaining and replacing artificial limbs for amputees adds to those patients' long-term costs, the study noted.

The analysis, appearing online Aug. 10 in advance of publication in the Sept. 15 issue of Cancer, reviewed previously published studies on the cost and quality of life for people undergoing limb-sparing surgery versus amputation. Its authors, Dr. Ronald Barr of McMaster University in Ontario and Dr. Jay Wunder of Mount Sinai Hospital and the University of Toronto, called for further and more comprehensive reviews into the matter to help doctors and patients make better decisions when facing the issue.

"Future studies that include function, health-related quality of life, economics and stratification of patients by age will be useful contributions to decision-making ... by patients, health-care providers and administrators," Wunder said in a news release from the American Cancer Society.

More information

The National Cancer Institute has more about soft-tissue sarcoma.

Posted: August 2009


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