Abstract
Background and objectivesThe purpose of this study is to analyze major complication rates and different aspects of health-related quality of life (HRQoL) in extremity soft tissue sarcoma (STS) patients treated with or without radio (chemo) therapy and surgery.MethodsWe performed a retrospective analysis of all patients who underwent Extremity STS excision from 2004 to 2014 (182 patients included). Patients’ data were collected from patients’ records. HRQoL was assessed by using EORTC QLQ-C30.ResultsA total of 182 patients underwent sarcoma resection. After neoadjuvant radiochemotherapy (RCT), the major-complication rate amounted to 28% (vs. 7%, no radiotherapy, p < 0.001). Major-complication rates after adjuvant radiotherapy (RT) occurred in 8% (vs. 7%, no radiotherapy, p = 0.265). Comparison QoL scores between treating with neoadjuvant RCT or without RT revealed significant worse scores with neoadjuvant RCT. Further stratification of disease control of these patients showed significant reduced scores in the group of disease-free patients with neoadjuvant RCT compared to irradiated disease-free patients.DiscussionTo date, there have only been a few investigations of QoL in STS. Retrospective study on quality of life have limitations, like a lack of baseline evaluation of QoL. Patient candidated to radiation therapy could have had worse QoL baseline due to more advanced disease. Disease status of the patients who answered the questionnaires could have been an influence of QoL and we could show reduced scores in the group of disease-free patients with neoadjuvant RCT, but not for the patients with recurrence or metastasis, so it is very hard to discriminate whether radiation therapy could really have an impact or not.ConclusionThis study might assist in further improving the understanding of QoL in STS patients and may animate for prospective studies examining the oncological therapies impact on HRQoL.
Highlights
Background and objectivesThe purpose of this study is to analyze major complication rates and different aspects of health-related quality of life (HRQoL) in extremity soft tissue sarcoma (STS) patients treated with or without radio therapy and surgery
In four cases (2%) only tumor mass debulking (R2) was performed. 49% of all included soft tissue sarcoma patients were treated with neoadjuvant RCT and adjuvant RT was used in 7%
In this study we present our results of soft tissue sarcoma patients QoL in a retrospective single-center study and tried to differentiated into different groups in case of radio therapy, compared to non-irradiated patients
Summary
The purpose of this study is to analyze major complication rates and different aspects of health-related quality of life (HRQoL) in extremity soft tissue sarcoma (STS) patients treated with or without radio (chemo) therapy and surgery. Radical surgery including limb amputation was often used to achieve wide longitudinal margins. Studies performed in the 1970s and 1980s showed no influence on overall survival, when limb-conserving surgery and adjuvant radiotherapy are combined, compared with radical amputation alone [1]. Prospective and retrospective studies have suggested that radiotherapy improves the local control rates in the setting of resectable disease and the overall survival [2, 3]. Newer retrospective analyses showing an impact by RT on survival in STS are largely open to criticism [4]. Many authors describe that wound complication rates are higher after preoperative irradiation, and long-term function is worse after postoperative irradiation, probably as a result of higher postoperative radiation doses, larger radiation fields, and resulting fibrosis [5, 6]
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