Sports activity after soft tissue sarcoma of the lower extremity

Abstract

Introduction: The aim of this case series was to assess sports activity levels in long-term survivors of soft-tissue sarcomas after multimodal treatment including limb salvaging surgical resection and radio-chemotherapy.

Methods: Thirty-two patients (17 f/15 m) with a mean age of 29 (range 10–44) years at the time of diagnosis and a mean follow-up time of 9 (range 3–21) years following sarcoma were included. Ten patients had been diagnosed with liposarcoma, seven with synovial sarcoma, four with fibrosarcoma, three with undifferentiated pleomorphic sarcomas and the remaining eight patients with different soft-tissue sarcoma entities. Sarcoma location of twenty-four (75%) patients was in the thigh, eight (25%) in the lower leg. Eleven (34%) tumors were located epifascial, 21 (66%) in deeper tissue layers. Sports activity was measured by the University of California, Los Angeles (UCLA) Activity Score.

Results: One year before treatment 30 patients (94%) and >3 years post-treatment 29 patients (91%)had been pursuing athletic activity regularly. They were performing 5.5 h/week prior and 4.2 h/week >3 years post surgery. The mean UCLA score in case of subfascial sarcomas was 8.0 and thereby lower (p < 0.05) than those of epifascial sarcomas, which were 9.3. Furthermore, the mean UCLA score after subfascial sarcoma resection 3 years postoperative was still below preoperative UCLA levels (p < 0.05), whereas patients after epifascial tumor resection showed no loss of sports activity. No relation between complications and postoperative sports activity level was found.

Conclusions: Healthy long-term survivors can achieve high levels of sports activity following limb salvage after soft-tissue sarcomas. The concerned muscle groups may influence the functional and sports outcome and draw attention to this topic in future rehabilitation. This knowledge may be of high value for patients counseling, physicians and orthopedists treating patients, as well as for patients inquiring information regarding post-treatment activity levels.

Implication for rehabilitation

• Sport is possible after soft tissue sarcoma treatment and longer-term rehabilitation which is usually three years

• Rehabilitation is best undertaken in specialized centers

• It is important to maintain contact with surgeons in order to optimize mobilization

• High impact sports may be affected by deep muscle resections.

Keywords:

• Cancer rehabilitation
• sports activity
• functional outcome
• UCLA
• Toronto Extremity Salvage Score

Disclosure statement

No potential conflict of interest was reported by the authors.