Negative Impact of Wound Complications on Oncologic Outcome of Soft Tissue Sarcomas of the Chest Wall.

Mehran Dadras,Pascal Koepp,Marcus Lehnhardt,Björn Behr,Christoph Wallner,Kamran Harati,Johannes Maximilian Wagner,Maxi Sacher

doi:10.3390/cancers12010101

Mehran Dadras, Pascal Koepp + Show 6 more

Open Access

https://doi.org/10.3390/cancers12010101

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Journal: Cancers	Publication Date: Dec 31, 2019
Citations: 5	License type: CC BY 4.0

Affiliation: BG University Hospital Bergmannsheil Bochum

Abstract

A link of complications with worse oncologic prognosis has been established for multiple malignancies, while the limited literature on soft-tissue sarcomas is inconclusive. The aim of this study was to examine risk factors and the oncologic impact of wound complications after curative resection of primary soft-tissue sarcomas of the chest wall. Patients with primary soft tissue sarcomas of the chest wall were identified. Groups with and without wound complications were compared by using univariate and multivariate analysis to identify risk factors. For patients with clear surgical margins (R0), univariate and multivariate analysis of factors associated with 5-year local recurrence free survival (LRFS), metastasis free survival (MFS), and disease specific survival (DSS) were performed. A total of 102 patients were included in the study. Wound complications occurred in 11 patients (10.8%) within 90 days. Cardiovascular morbidity and operation time represented independent risk factors for wound complications. In 94 patients with clear surgical margins, those with wound complications had an estimated 5-year LRFS of 30% versus 72.6% and a 5-year DSS of 58.3% versus 82.1%. Wound complications could be identified as an independent predictor for worse LRFS and DSS. Patients with a high risk of wound complications should be identified and strategies implemented to reduce surgical complications and possibly improve oncologic prognosis.

Highlights

Soft tissue sarcomas (STS) represent a heterogeneous group of malignant tumors with mesenchymal origin and represent around 1% of all adult malignancies [1]
A total of 144 patients with STS of the chest wall were treated at our institution between January
After excluding 38 patients who initially presented with a sarcoma recurrence, two patients with metastatic disease upon diagnosis, and two patients with missing relevant data, the remaining 102 patients were included in the study

Summary

Introduction

Soft tissue sarcomas (STS) represent a heterogeneous group of malignant tumors with mesenchymal origin and represent around 1% of all adult malignancies [1]. Surgical resection is considered to be the cornerstone of treatment, while complete resection offers the potential for curative treatment. Among the factors that are predictive for oncologic outcome, surgical margins, histological grade and subtype, tumor size, and depth are considered to be the most significant [2,3,4,5,6]. Multiple studies have addressed the impact of multimodal therapy on the treatment of STS. While radiotherapy has been shown to improve local control, the timing of therapy as adjuvant or neoadjuvant has been a subject for debate. It could be observed that neoadjuvant radiotherapy increases the risk of wound complications, whereas more fibrosis has been observed in adjuvant application [7,8,9]

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