Nomogram Predicting the Risk of Postoperative Major Wound Complication in Soft Tissue Sarcoma of the Trunk and Extremities after Preoperative Radiotherapy

Abstract

Preoperative radiotherapy increases the risk of postoperative wound complication in the treatment of soft tissue sarcoma (STS). This study aims to develop a nomogram for predicting major wound complication (MaWC) after surgery. Using the Oxford University Hospital (OUH) database, a total of 126 STS patients treated with preoperative radiotherapy and surgical resection between 2007 and 2021 were retrospectively reviewed. MaWC was defined as a wound complication that required secondary surgical intervention. Univariate and multivariate regression analyses on the association between MaWC and risk factors were performed. A nomogram was formulated and the areas under the Receiver Operating Characteristic Curves (AUC) were adopted to measure the predictive value of MaWC. A decision curve analysis (DCA) determined the model with the best discriminative ability. The incidence of MaWC was 19%. Age, tumour size, diabetes mellitus and metastasis at presentation were associated with MaWC in the univariate analysis. Age, tumour size, and metastasis at presentation were independent risk factors in the multivariate analysis. The sensitivity and specificity of the predictive model is 0.90 and 0.76, respectively. The AUC value was 0.86. The nomogram constructed in the study effectively predicts the risk of MaWC after preoperative radiotherapy and surgery for STS patients.

A novel nomogram and prognostic factor for metastatic soft tissue sarcoma survival

“…Consequently, our understanding of STS is often derived from retrospective studies, given the limited feasibility of prospective trials in this context. While the prevailing emphasis in existing retrospective studies predominantly centers on evaluating the prognostic implications associated with surgical interventions (14,15), there exists a conspicuous gap in the exploration of factors that impact the effectiveness of chemotherapy and radiotherapy in the era of ICIs (11). This identified void in the literature underscores the pressing need for additional and targeted investigative endeavors in this specific domain of research.…”