Functional Outcomes and Quality of Life in Patients with Extremity Soft Tissue Sarcoma: A Longitudinal Analysis at a Tertiary Care Teaching Hospital

Abstract

Background: Soft tissue sarcomas (STS) of the extremities are rare malignancies whose treatment prioritizes both oncologic control, preservation of limb function and quality of life (QoL). Conventional survival metrics inadequately capture the functional and psychosocial impact of limb-salvage surgery and adjuvant therapies. Objective: To evaluate postoperative functional outcomes and QoL in patients with extremity STS treated by limb-salvage surgery at a tertiary care centre, and to identify associated clinical factors. Methods: This cross-sectional observational study enrolled 46 consecutive patients with extremity STS who underwent surgical management at Maharaja Yashwantrao Hospital (MY Hospital), Indore, between 2023 and 2024. Functional outcome was assessed with the Toronto Extremity Salvage Score (TESS) and QoL with the EORTC QLQ-C30 questionnaire at 1 week, 2 weeks, 4 weeks and 3 months postoperatively. Patient demographics, tumour factors, treatment methods and complication data were recorded. Statistical analysis used descriptive statistics, correlation coefficients, multivariate linear regression and ANOVA (SPSS; significance p < 0.05). Results: Mean age was 43.3 ± 16.9 years; 54 % were male. Upper-limb tumours predominated (57 %). Surgery alone was performed in 83 % of cases; flap reconstruction was required in 65 %. Mean TESS scores remained high and stable (80.4 at 1 week to 80.6 at 3 months). Mean QLQ-C30 scores showed an initial decline followed by stabilisation (82.1 at 1 week to 77.0 at 3 months). Multivariate regression demonstrated significant negative associations of age (β = −0.21, p = 0.03) and BMI (β = −0.34, p = 0.02) with TESS, and of age and BMI with QoL scores at 3 months. Postoperative complication rate was low (16 %). Local recurrence and distant metastasis rates were not the primary focus of the reported analyses. Conclusion: Limb-salvage surgery for extremity STS yields high and relatively stable functional scores and acceptable QoL in the early postoperative period. Older age and higher BMI independently predict poorer functional and QoL outcomes, underscoring the need for individualised rehabilitation and weight-management strategies. Larger prospective multicentre studies with longer follow-up are warranted.