Anatomic Tumor Location Influences the Success of Contemporary Limb-Sparing Surgery and Radiation Among Adults With Soft Tissue Sarcomas of the Extremities

Korah, M.P.; Deyrup, Andrea T.; Monson, David K.; Oskouei, Shervin V.; Weiss, Sharon W.; Landry, Jerome C.; Godette, Karen D.

doi:10.1016/j.ijrobp.2010.11.020

Cited by 41 publications

(43 citation statements)

References 15 publications

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“…Rimner et al 10 Numerous retrospective reviews have assessed postoperative complications in patients with lower extremity LSS for STS and have found an overall complication rate of 22% to 45%. 7,[12][13][14]16,18,[20][21][22][23][24][25][26] In the thigh, this range is 28% to 54%. 12,[18][19][20]27,28 some of these results obsolete.…”

Section: Complicationsmentioning

confidence: 99%

“…STS of the lower extremity are known to be associated with more complications than those in the upper extremity. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] Lower extremity tumors tend to be larger, resulting in more disruption of local structures 7. Moreover, studies have shown that within the lower extremity, tumors within the thigh have a higher complication and reoperation rate.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, studies have shown that within the lower extremity, tumors within the thigh have a higher complication and reoperation rate. 7,[11][12][13]15,16,20,21 Our objectives were to (a) determine which factors are associated with postoperative wound complications after thigh STS reconstruction by plastic surgeons, and (b) determine if changes in technology, surgical techniques, or advances in multi-modality therapy have altered the overall complication rates associated with these challenging cases.…”

Section: Introductionmentioning

confidence: 99%

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Complications after thigh sarcoma resection

Elswick

Curiel

et al. 2020

Journal of Surgical Oncology

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Background and Objectives Standard treatment for extremity sarcoma is limb‐sparing surgery often with radiation, but complications occur frequently. We sought to determine factors predictive of wound complications after thigh sarcoma resection and reconstruction while analyzing trends over time. Methods We reviewed all thigh defects requiring plastic surgeon reconstruction following sarcoma resection at our institution from 1997 to 2014. Patient demographics, comorbidities, operative characteristics, multi‐modality therapies, and complications were analyzed. Wound complications were: infection, dehiscence, seroma, hematoma, or partial/total flap loss. Results There were 159 thigh reconstructions followed for 30 months on average. Eighty‐seven percent of patients underwent radiation and 42% had chemotherapy. Almost half (49.1%) had a complication. The most common wound complication was surgical site infection (23.3%) followed by dehiscence (19.5%), and seroma (10.7%). Less common were partial (2.5%) or total flap loss (0.6%). Reoperation was required in 21 patients (13.2%). Tobacco use, older patient age, cardiac disease, and higher body mass index were independently associated with wound complications. Complications trended towards decreasing over time, but this was not statistically significant. Conclusions Tobacco use, cardiac disease, and higher body mass index, but not the timing of reconstruction, appear to increase the risk of wound complications after thigh soft tissue sarcomas resection and plastic surgery reconstruction.

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Section: Complicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Complications after thigh sarcoma resection

Elswick

Curiel

et al. 2020

Journal of Surgical Oncology

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“…Soft tissue sarcoma (STS) is a rare tumor accounts for less than 1% of all newly diagnosed malignant diseases and extremity is the most common site of origin [1]. STS extensively invades surrounding soft tissue, so local recurrence rates are as high as 30% to 50% with local excision only [2].…”

Section: Introductionmentioning

confidence: 99%

Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma

et al. 2012

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PurposeTo evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS).Materials and MethodsForty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy.ResultsThe median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%).ConclusionConservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.

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“…High-dose radiation is injurious to bone and is a known risk factor for the development of late fractures [3]. The incidence of femur fracture following STS resection and radiotherapy ranges from 5-9% [2,[4][5][6][7]. Little data exists on the rate of pathological fractures in the upper limb.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Soft Tissue Sarcoma Excision and Prophylactic and Bony Fixation of the Upper Limb: Expediting Radiotherapy and Reducing Fracture Risk

Wjm¹

2014

Anaplastology

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Anatomic Tumor Location Influences the Success of Contemporary Limb-Sparing Surgery and Radiation Among Adults With Soft Tissue Sarcomas of the Extremities

Cited by 41 publications

References 15 publications

Complications after thigh sarcoma resection

Complications after thigh sarcoma resection

Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma

Simultaneous Soft Tissue Sarcoma Excision and Prophylactic and Bony Fixation of the Upper Limb: Expediting Radiotherapy and Reducing Fracture Risk

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