Comparison of quality of life after amputation or limb salvage.

In the past, amputation was the standard method of treatment for patients with sarcomas in the extremity but limb-sparing procedures now are much more frequent. A computerized questionnaire automatically adjusted for gender, age, diagnosis, site, and treatment was sent to 2200 patients with high-grade sarcomas who had been treated during the past 25 years. Using the data, it was possible to study and compare the response from 66 patients who had an amputation and 342 patients with a limb-sparing procedure for a lower extremity neoplasm. More males had an amputation, but no differences were observed in the ages of the two groups. The outcomes for the two groups were similar. Patients who had limb-sparing procedures did not have a significant improvement in the ability to ambulate, climb stairs, drive a car, or be employed. More of the patients with amputations required walking aids and participated in sports activities at almost the same rate as the patients who had limb-sparing procedures. Patients who had amputations had no more anxiety, drug-dependence, depression, sleep problems, or limitation of sexual performance than patients who retained their limbs. The patients with amputations had more children and fewer menstrual problems; however, they were far less satisfied with their status at early ages than at later periods in their lives.