Wound complications are a predictor of worse oncologic outcome in extremity soft tissue sarcomas |
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| Institution: | 1. Comprehensive Cancer Center – Musculoskeletal Tumors, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;2. Department of Internal Medicine I/Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;3. Department of Thoracic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;4. Department of Pathology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;5. Department of Orthopedics, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;6. Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;7. Sarcoma Platform Austria, Austria;1. Division of Plastic and Reconstructive Surgery, Department of Surgical Oncology, University Health Network, Department of Surgery, University of Toronto, Toronto, Canada;2. Department of Surgical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands;3. University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Department of Surgical Oncology, University Health Network, Department of Surgery, University of Toronto, Toronto, Canada;4. Department of Surgical Oncology, Leiden University Medical Centre, Leiden, The Netherlands;1. Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK;2. Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan;1. Unité de chirurgie plastique et réparatrice, centre Léon-Bérard, 28, rue Laennec, Lyon, France;2. Unité de chirurgie digestive et des sarcomes, centre Léon-Bérard, 28, rue Laennec, Lyon, France;1. Medizinisches Proteom-Center, Ruhr-University Bochum, Bochum, Germany;2. BG University Hospital Bergmannsheil, Department of Plastic Surgery, Bochum, Germany |
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| Abstract: | BackgroundIn 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.MethodsPatients 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.Results682 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 2.68CI 1.83–3.93], p < 0.001) and DSS (HR 1.79CI 1.01–3.16], p = 0.046).ConclusionWound 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. |
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| Keywords: | Soft tissue sarcoma Wound complications Tumor |
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