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

Mustafa Çeltik; Özlem Orhan; Gülsüm Öztürk Emiral; Kemal Yücel; Hayati Hürol Türkoğlu; Coşkun Ulucaköy; İsmail Burak Atalay

doi:10.52312/jdrs.2026.2663

Mustafa Çeltik¹, Özlem Orhan², Gülsüm Öztürk Emiral³, Kemal Yücel², Hayati Hürol Türkoğlu², Coşkun Ulucaköy², İsmail Burak Atalay²

¹Department of Orthopedics and Traumatology, İzmir Bakırçay University, İzmir Türkiye
²Department of Orthopedics and Traumatology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Türkiye
³Department of Internal Medicine, Division of Public Health, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Türkiye

Keywords: Bone tumors, EQ-5D-5L, health-related quality of life, patientreported outcome measures, SF-12, upper extremity.

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.

Citation: Çeltik M, Orhan Ö, Öztürk Emiral G, Yücel K, Türkoğlu HH, Ulucaköy C, et al. Health-related quality of life in patients undergoing surgery for upper extremity bone tumors: A crosssectional study. Jt Dis Relat Surg 2026;37(2):501-509. doi: 10.52312/ jdrs.2026.2663.