Wound complications are a predictor of worse oncologic outcome in extremity soft tissue sarcomas.
Adult
Aged
Disease-Free Survival
Extremities
/ surgery
Female
Humans
Leiomyosarcoma
/ mortality
Liposarcoma
/ mortality
Male
Margins of Excision
Middle Aged
Neoadjuvant Therapy
/ statistics & numerical data
Neoplasm Grading
Neoplasm Recurrence, Local
/ epidemiology
Operative Time
Prognosis
Radiotherapy
/ statistics & numerical data
Plastic Surgery Procedures
Risk Factors
Sarcoma
/ mortality
Soft Tissue Neoplasms
/ mortality
Surgical Wound Infection
/ epidemiology
Tumor Burden
Soft tissue sarcoma
Tumor
Wound complications
Journal
Surgical oncology
ISSN: 1879-3320
Titre abrégé: Surg Oncol
Pays: Netherlands
ID NLM: 9208188
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
05
10
2019
revised:
19
01
2020
accepted:
14
02
2020
entrez:
21
6
2020
pubmed:
21
6
2020
medline:
27
4
2021
Statut:
ppublish
Résumé
In various oncological conditions, complications correlate with diminished prognosis, however literature on soft tissue sarcomas is limited and inconclusive. The aim of this study was to assess risk factors and the oncologic impact of wound complications in primary extremity soft-tissue sarcomas. Patients with primary extremity soft tissue sarcomas without dissemination and with clear surgical margins (R0) were analyzed. Groups with and without wound complications were compared by univariate and multivariable analysis to identify risk factors. Uni- and multivariable analysis of factors associated with local recurrence free survival (LRFS), metastasis free survival (MFS) and disease specific survival (DSS) were performed. 682 patients were included in the study, wound complications occurred in 94 patients (13.7%) within 90 days. Age, ASA-stage, high tumor size and grade, tumor location in the foot, neoadjuvant radiation therapy and operation time represented independent risk factors for wound complications. Patients with wound complications had a significantly worse estimated 5-year LRFS of 49.4 ± 6% versus 78.3 ± 2.1% and 5-year DSS of 77.9 ± 5.4% versus 89.1 ± 1.6%. Wound complications could be identified as an independent risk factor for worse LRFS (HR 2.68[CI 1.83-3.93], p < 0.001) and DSS (HR 1.79[CI 1.01-3.16], p = 0.046). Wound complications after soft tissue sarcomas of the extremities are associated with worse local oncological outcome and survival. Patients with high risk of wound complications should be identified and strategies implemented to reduce surgical complications and possibly improve oncologic prognosis.
Sections du résumé
BACKGROUND
BACKGROUND
In various oncological conditions, complications correlate with diminished prognosis, however literature on soft tissue sarcomas is limited and inconclusive. The aim of this study was to assess risk factors and the oncologic impact of wound complications in primary extremity soft-tissue sarcomas.
METHODS
METHODS
Patients with primary extremity soft tissue sarcomas without dissemination and with clear surgical margins (R0) were analyzed. Groups with and without wound complications were compared by univariate and multivariable analysis to identify risk factors. Uni- and multivariable analysis of factors associated with local recurrence free survival (LRFS), metastasis free survival (MFS) and disease specific survival (DSS) were performed.
RESULTS
RESULTS
682 patients were included in the study, wound complications occurred in 94 patients (13.7%) within 90 days. Age, ASA-stage, high tumor size and grade, tumor location in the foot, neoadjuvant radiation therapy and operation time represented independent risk factors for wound complications. Patients with wound complications had a significantly worse estimated 5-year LRFS of 49.4 ± 6% versus 78.3 ± 2.1% and 5-year DSS of 77.9 ± 5.4% versus 89.1 ± 1.6%. Wound complications could be identified as an independent risk factor for worse LRFS (HR 2.68[CI 1.83-3.93], p < 0.001) and DSS (HR 1.79[CI 1.01-3.16], p = 0.046).
CONCLUSION
CONCLUSIONS
Wound complications after soft tissue sarcomas of the extremities are associated with worse local oncological outcome and survival. Patients with high risk of wound complications should be identified and strategies implemented to reduce surgical complications and possibly improve oncologic prognosis.
Identifiants
pubmed: 32561077
pii: S0960-7404(19)30497-9
doi: 10.1016/j.suronc.2020.02.016
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
126-134Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing of interest The author(s) received no specific funding for this work and declare not conflict of interest.