The AAPS 101st Annual Meeting

Spare The Limb And Spoil The Outcome: Why Do Some Osteosarcoma Patients Pursue Amputation Post LSS?

Background:

•There are ~1,000 new cases of osteosarcoma each year

•Majority of cases in children and teens

•Most commonly in lower limb

•Treatment includes:

•Surgery

•Chemotherapy and/or radiation therapy

•Surgical treatments include: amputation, limb sparing surgery (LSS), rotationplasty (RP)

•In the past, limb sparing was not an option offered

•Innovation in flaps and endoprosthesis has allowed for more LSS and has become the gold standard of treatment

•However, some patients who undergo LSS may choose to transition to an amputation-type revision, including rotationplasty

Purpose:

•Prior research has examined the psychosocial and physical outcomes, and overall satisfaction associated with secondary surgical interventions.

•Little is known about patient reported pain and other outcomes before and after secondary intervention.

•We wanted to determine motivating factors for decision to transition to amputation-type revision and whether those interventions better address those factors.

Methods:

•The public Osteosarcoma Facebook group: "Osteosarcoma and Ewing's Sarcoma Support Group" was chosen.

•Posts containing "LSS," ”Limb Sparing Surgery" "Amputation," "Rotationplasty," & "Pain" from June 1, 2021 through June 30, 2022 were selected.

•Posts regarding non-surgical osteosarcoma interventions, oncology, upper limb surgical intervention were excluded.

•Deidentified transcripts were uploaded to ATLAS.ti, coding software.

•Two investigators independently coded each posts and met to perform inductive analysis of codes.

•Discrepancies were resolved with discussion.

Results:

A total of 14 posts and 378 comments from the Osteosarcoma and Ewing's Sarcoma Support Group were analyzed. The following themes emerged: Living with LSS, Regret Associated with LSS, Concerns Associated with Amputation, Amputation-Type Experience, LSS to Amputation-Type Experience.

Conclusions:

•LSS can result in significant pain and negatively impact on quality of life.

•As a result, some patients choose alternative treatments, like amputation and rotationplasty.

•Future work is needed to understand how to better counsel patients on these life-saving and life-changing procedures.

The AAPS 101st Annual Meeting

Spare The Limb And Spoil The Outcome: Why Do Some Osteosarcoma Patients Pursue Revision Amputation And Does The Amputation Improve The Outcome?

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