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Joint Diseases and
Related Surgery
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Original Article · Open access

Health-related quality of life in patients undergoing surgery for upper extremity bone tumors: A cross-sectional study

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Mustafa Çeltik

Department of Orthopedics and Traumatology, İzmir Bakırçay University, İzmir Türkiye

ORCID: 0000-0002-0517-6684

Özlem Orhan

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0001-7508-135X

Gülsüm Öztürk Emiral

Department of Internal Medicine, Division of Public Health, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye

ORCID: 0000-0001-8781-4127

Kemal Yücel

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0009-0003-5605-7831

Hayati Hürol Türkoğlu

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0002-6422-4949

Coşkun Ulucaköy

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0002-6991-5511

İsmail Burak Atalay

Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0002-6210-4193

Abstract

Objectives: This study aims to evaluate health-related quality of life (HRQoL) in patients who underwent surgical treatment for upper extremity bone tumors, using validated patient-reported outcome measures, and to explore clinical factors associated with better or worse outcomes.

Patients and methods: Between January 2015 and January 2024, a total of 55 patients (26 males, 29 females; mean age: 42.4 ± 19.0 years; range, 16 to 81 years) who were treated surgically for upper extremity bone tumors and evaluated at least six months postoperatively were included. The patients completed the EuroQol EQ-5D-5L and the Short Form-12 (SF-12) questionnaires. Clinical variables included age, sex, tumor site, pathology, treatment modality, and adjuvant or neoadjuvant therapies.

Results: The humerus was the most frequent tumor site (60%), and joint involvement was present in 80% of cases. Benign tumors accounted for two-thirds of patients, while malignant tumors represented one-third. Curettage-based procedures predominated, and only two patients required amputation. Postoperative complications and recurrences were both observed in 7.3% of patients. On the EQ-5D-5L, 65.5% of patients reported no difficulty with mobility or self-care, but half experienced limitations in usual activities. Pain and discomfort were reported by 74.5%, and anxiety or depression by 67.3%. The mean EQ-5D-5L index was 0.55 ± 0.49 and the mean EQ-VAS was 70.9 ± 20.1. The mean SF-12 physical component score (PCS) and mental component score (MCS) were 42.6 ± 11.3 and 47.0 ± 11.2, respectively, indicating that physical functioning was more impaired than mental well-being. Correlation analyses demonstrated strong associations between EQ-5D-5L, EQ-VAS, and SF-12 scores, supporting convergent validity. Subgroup analyses revealed that younger patients (< 50 years), those with benign pathology, and individuals without adjuvant or neoadjuvant therapies reported significantly higher HRQoL scores.

Conclusion: Patients undergoing surgery for upper extremity bone tumors frequently experience pain and psychological distress despite preserved independence in mobility and self-care. Age, pathology, treatment intensity and tumor location were associated with HRQoL. These findings highlight the importance of rehabilitation and psychosocial support in postoperative care, alongside oncological and surgical management.

Declarations

Author Contributions

M.C., O.O., G.O.E.: Idea/concept, literature review, analysis and/or interpretation; M.C., O.O., G.O.E., K.Y.: Design: M.C., G.O.E.: Control/supervision; O.O., K.Y., H.H.T., C.U., I.B.A.: Data collection and/or processing; M.C., O.O.: Writing the article, references and fundings; G.O.E., K.Y., H.H.T., C.U., I.B.A.: Critical review; K.Y., H.H.T., C.U., I.B.A.: Materials.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

AI Disclosure

The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

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