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

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.

Antibiotic prophylaxis for prevention of wound infections after soft tissue sarcoma resection: A retrospective cohort study

“…Surgical site infections are considered one of the most relevant complications after tumor resection and have been shown to occur in approximately 21% of cases 3 . In recent studies, we were able to show that wound complications after STS resection have a major impact not only on the immediate postoperative course but also on the oncological outcome, adversely affecting local recurrence‐free survival and disease‐specific survival 4 …”

“…3 In recent studies, we were able to show that wound complications after STS resection have a major impact not only on the immediate postoperative course but also on the oncological outcome, adversely affecting local recurrence-free survival and disease-specific survival. 4 Therefore, strategies to prevent wound complications are of utmost relevance as these might improve immediate postoperative course as well as long term outcome.…”

Risk Factors for Occurrence and Relapse of Soft Tissue Sarcoma

“…In 2019, Dadras et al demonstrated the oncologic impact of wound complications after curative resection of primary soft tissue sarcomas of the chest wall [ 37 ]. Patients with wound complications had an estimated 5-year local recurrence-free survival (LRFS) of 30% versus 72.6%, and a 5-year disease-specific survival (DSS) of 58.3% versus 82.1%.…”

“…Among these factors, next to histological grade, tumor size, depth, and histological subtype, future episodes of local recurrence, margins of resection and postoperative treatment with radiation or chemotherapy are the most significant [ 13 , 60 , 61 ]. Another interesting prognostic factor was examined in the Dadras et al study (2020) where wound complications have been identified to be an independent predictor of local recurrence and disease specific death of primary STS of the chest wall [ 37 ].…”

Bone and Soft Tissue Tumors: New Treatment Approaches

“…Therefore, it is thought that postoperative wound complications may exacerbate the clinical outcomes in patients with bone and soft tissue tumors. Dadras et al investigated the relationship between postoperative wound complications and oncological outcomes in 102 patients with soft tissue sarcomas of the chest wall [ 19 ]. Among the study patients, 11 (11%) experienced wound complications after tumor excision.…”