The Oncologic Impact of Postoperative Complications Following Resection of Truncal and Extremity Soft Tissue Sarcomas

Broecker, Justine S.; Ethun, Cecilia G.; Monson, David K.; Lopez‐Aguiar, Alexandra G.; Le, Nina; McInnis, Mia R.; Godette, Karen D.; Reimer, Nickolas B.; Oskouei, Shervin V.; Delman, Keith A.; Staley, Charles A.; Maithel, Shishir K.; Cardona, Kenneth

doi:10.1245/s10434-017-6034-9

Cited by 17 publications

(25 citation statements)

References 61 publications

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“…However, oncology databases such as SEER fail to adequately capture patient comorbidities and early postoperative complications [11][12][13]. Early complications of surgery can delay adjuvant therapy, potentially affecting long-term oncologic outcomes [14]. erefore, knowledge of risk profiles for specific tumors and procedures is necessary for adequate preoperative planning and postoperative surveillance.…”

Section: Introductionmentioning

confidence: 99%

Thirty-Day Outcomes after Surgery for Primary Sarcomas of the Extremities: An Analysis of the NSQIP Database

Gallaway

Ahn

Callan

2020

Journal of Oncology

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Background. Primary bone and soft tissue sarcomas are rare tumors requiring wide surgical resection and reconstruction to achieve local control. Postoperative complications can lead to delays in adjuvant therapy, potentially affecting long-term oncologic outcomes. Understanding postoperative complication risks is essential; however, past studies are limited by small sample sizes. Purpose. This study uses a large national registry to characterize the incidence of complications and mortality in the first thirty days following surgical management of primary bone and soft tissue sarcomas of the extremities. Methods. A retrospective review of patients in the National Surgical Quality Improvement Program database was performed. Cases were identified using diagnosis codes for malignant neoplasm of soft tissue or bone and procedure codes for amputation and radical resection. The cohort was subdivided by bone versus soft tissue sarcoma, upper versus lower extremity, and amputation versus limb salvage. Results. One thousand, one hundred eleven patients were identified. The most frequent complications were surgical site infections, sepsis, and venous thromboembolism. The overall incidence of complications was 14.0%. Unplanned readmission and reoperation occurred after 7.0% and 8.0% of cases, respectively. Thirty-day mortality was 0.3%, with one intraoperative death. Patient factors and complication rates varied by tumor location and surgical modality. Lower extremity cases were associated with higher rates of wound complications and infectious etiologies such as surgical site infections, urinary tract infections, and systemic sepsis. In contrast, patients undergoing amputation were more likely to experience major medical complications including acute renal failure, cardiac arrest, and myocardial infarction. Conclusion. Approximately 1 in 7 patients will experience a complication in the first thirty days following surgery for primary bone and soft tissue sarcomas of the extremities. The unique risk profiles of lower extremity and amputation cases should be considered during perioperative planning and surveillance.

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Section: Introductionmentioning

confidence: 99%

Thirty-Day Outcomes after Surgery for Primary Sarcomas of the Extremities: An Analysis of the NSQIP Database

Gallaway

Ahn

Callan

2020

Journal of Oncology

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“…Behnke et al did not find a correlation of infectious wound complications with LRFS, MFS or DSS in 396 soft tissue sarcomas of the extremities with unreported median follow-up [19]. In contrast, Broecker et al did find a significant impact of general complications on DSS in 546 patients with extremities and trunk STS after a median follow-up of 37 months, while influence on local recurrence was not significant [20].…”

Section: Discussionmentioning

confidence: 96%

“…So far, only two studies have addressed the impact of surgical complications on oncologic outcome of STS to our knowledge [19,20]. Both studies included patients with STS in different locations, incomplete resections, and significant differences in the application of multimodal therapy of the compared subgroups, representing possible biases for the results.…”

Section: Introductionmentioning

confidence: 99%

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

Dadras

Koepp

Wagner

et al. 2019

Cancers

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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.

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“…Furthermore, limiting morbidity is paramount. The occurrence of a postoperative complication in a large study analyzing 546 STS patients including those involving the trunk revealed an adverse survival (41). The data incorporating chemotherapy as well as radiotherapy in extremity STS perioperatively can generally be applied to the trunk but suffer from practice patterns that are highly variable.…”

Section: Treatmentmentioning

confidence: 99%

Surgical management of truncal soft tissue sarcoma and other selected soft tissue neoplasms

Morita

2018

Chin. Clin. Oncol.

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Soft tissue sarcoma (STS) is a heterogeneous entity comprising only 1% of all adult cancers that has received considerable attention since it was initially described after the 1st century as "fleshy" by Claudius Galenus. Nick-named the forgotten cancer, more than 100 histologic subtypes have been identified making treatment paradigms extremely complex. A key principle in the management of truncal STS is a defined multi-disciplinary team consisting of several providers. In most instances, surgery is the cornerstone of treatment. This overview will focus on the management of truncal sarcoma from a surgical perspective that will entail several points of consideration including histologic subtype, degree of differentiation, margin status as well as necessity of reconstruction; it will also include discussion of other unique soft tissue neoplasms relevant to the breast and abdominal wall.

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The Oncologic Impact of Postoperative Complications Following Resection of Truncal and Extremity Soft Tissue Sarcomas

Cited by 17 publications

References 61 publications

Thirty-Day Outcomes after Surgery for Primary Sarcomas of the Extremities: An Analysis of the NSQIP Database

Thirty-Day Outcomes after Surgery for Primary Sarcomas of the Extremities: An Analysis of the NSQIP Database

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

Surgical management of truncal soft tissue sarcoma and other selected soft tissue neoplasms

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