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Functional Outcomes and Quality of Life After Tumor-Related Hemipelvectomy

LA Beck, MS, RN, CNS, is Assistant Professor of Nursing, College of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (USA).
MJ Einertson, PT, DPT, is Staff Physical Therapist, College of Medicine, Mayo Clinic.
MH Winemiller, MD, is Instructor and Consultant in Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic.
RW DePompolo, MD, is Assistant Professor of Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic.
KM Hoppe, MD, is Instructor and Consultant in Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic.
FF Sim, MD, is Professor of Orthopedics, Department of Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic.

beck.lisa{at}mayo.edu

Background and Purpose: Hemipelvectomy is a life-changing treatment for pelvic malignancies. This study compared functional outcomes and quality of life of patients following internal or external hemipelvectomies.

Subjects: Ninety-seven patients who underwent tumor-related internal (n=39) or external (n=58) hemipelvectomy surgery between January 1, 1988, and December 31, 2004, participated in the study.

Methods: Using a descriptive retrospective cohort study design, functional status was evaluated with the Barthel Index at 3 time points. Quality-of-life parameters were evaluated at follow-up using the Linear Analog Self-Assessment tool (LASA).

Results: Data were collected on all 97 patients at rehabilitation consultation and hospital discharge. Follow-up data were obtained via survey on 44% of the original group at a median of 5.8 years (interquartile range [IRQ]=1.7–10.4) after surgery. Median total Barthel Index scores were similar between the internal and external hemipelvectomy groups at the initial physical medicine and rehabilitation assessment (10 [IQR=10–15] versus 10 [IQR=3.75–15]), at discharge (40 [IQR=30–65] versus 50 [IQR=35–66.25]), and at follow-up (92.5 [IQR=76.25–100] versus 92.5 [IQR=78.75–96.25]). Participants with external hemipelvectomies were less independent in bladder function and experienced greater pain severity at follow-up compared with those with internal hemipelvectomies. Overall quality-of-life parameters were similar between the groups.

Discussion and Conclusion: Despite significant differences in surgical procedures, immediate and long-term functional outcomes and quality-of-life parameters were similar among participants with internal and external hemipelvectomies.

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