(P 497) STANMORE TUMOUR OUTCOMES PROJECT (STOMP)- USING INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH (ICF) OUTCOMES IN SARCOMA SURVIVORS. and UNDERSTANDING THE EXPERIENCES OF PATIENTS RETURNING TO DAILY ACTIVITES AND EXERCISE FOLLOWING LIMB SPARING SURGERY FOR BONE OR SOFT TISSUE SARCOMA AROUND THE KNEE

Objective: Surgical interventions aimed at managing musculoskeletal tumours, including sarcomas, result in notable physical limitations for patients. The Stanmore OutcoMes Project (SOMP) aims to comprehensively identify the physical, psycho-social, functional limitations experienced by patients who have undergone surgeries for musculoskeletal tumours, including massive endoprosthesis replacements, amputations, and reconstruction procedures.

Methods: Utilizing a bio-psycho-social approach of the International Classification of Functioning, Disability, and Health (ICF) model, this cross-sectional study (Ethical approval reference number: 21/WA/0027; IRAS ID: 291087 – 10 years) incorporates questionnaires, individual ICF assessments, interviews, 3D Accelerometery and gait analysis.

The study recruited 91 participants over 19 months, (82 adults, 9 children; 59 males, 32 females; 88 diagnosis of malignant tumour, 3 benign; 83 Lower Limb, 8 Upper Limb Surgeries) with mean age 46.84± 21.12. These included osteosarcoma(n=29: 31.8%), chondrosarcoma(n=17: 18.6%), ewings sarcoma (n=6: 6.6%) and other diagnoses(n=39: 42.8%) and were recruited 65.14+-71.41 months post-surgery. A selected cohort underwent gait assessment in motor learning laboratory, activity monitoring with 3D accelerometer and qualitative interviews. Data were analysed using SPSS or thematic analysis.

Results: The mean scores of Toronto Extremity Limb Salvage Score(TESS) [670.39±21.43], Quality of Life for Cancer Survivors (QOL-CS) [5.69±1.59], EuroQol Questionnaire(EQ-5D) [66.93 ± 19.78 - Index: 21222] and modified Re-integration to Normal Living (mRNL) [70.09±24.53] suggested poorer outcomes than reference values. ICF assessment revealed patient specific participation restriction and barriers related to work environment, use of public transport, acceptance of limitations.

Data for community accelerometery (n=26) demonstrated variability in daily averages of step counts(mean=6117±3961 steps/day), energy expenditure 32.8± 1.6 metabolic equivalents (METs). Higher bouts of inactivity, lower step count was present in patients with secondary complications reflecting reduced activity levels.

Qualitative interviews (n=20) revealed the need for improved psychological support and post-surgery expectation information. Gait analysis performed on patients who underwent pelvic surgeries showed poorer posterior and medial balance and statistically significant difference in gait profile score when compared with healthy individuals.

Conclusion: The initial findings indicate that patients treated for musculoskeletal tumours experience moderate impacts on their quality of life and gait, with those experiencing secondary complications being more prone to inactivity and diverse impairments encompassing functional, environmental, and psychological aspects. This feasibility study also demonstrated STOMP as a versatile platform for comprehensive outcome collection in musculoskeletal tumour patients, allowing tailored assessments.