Predictors for Major Wound Complications Following Preoperative Radiotherapy and Surgery for Soft-Tissue Sarcoma of the Extremities and Trunk: Importance of ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-05

AUTHORS

Elizabeth H. Baldini, Michelle R. Lapidus, Qian Wang, Judith Manola, Dennis P. Orgill, Bohdan Pomahac, Karen J. Marcus, Monica M. Bertagnolli, Phillip M. Devlin, Suzanne George, John Abraham, Marco L. Ferrone, John E. Ready, Chandrajit P. Raut

ABSTRACT

PURPOSE: Preoperative and postoperative RT for the treatment of high-grade soft-tissue sarcoma result in similar local control and overall survival rates, but morbidities differ. Postoperative RT is associated with a higher rate of long-term fibrosis, edema, and joint stiffness. Preoperative RT is associated with higher rates of wound complications. It is important to identify predictors for major wound complications (MWC) and to develop strategies to minimize this outcome. We reviewed our experience to determine predictors for MWC following preoperative radiotherapy (RT) and surgery for soft-tissue sarcoma. METHODS: Between January 2006 and May 2011, 103 patients with soft-tissue sarcoma of the extremities and trunk were treated with preoperative RT followed by surgery. MWCs were defined as those requiring operative or prolonged nonoperative management. Fisher's exact test was used to compare rates. Logistic regression was used for multivariable analysis of factors potentially associated with MWCs. RESULTS: Median tumor size was 8.4 cm (range 2-25). All patients had wide or radical resections. Wound closures were primary in 70 %, a vascularized flap in 27 %, and split-thickness skin graft (STSG) in 3 %. There were 36 MWCs (35 %). Significant predictors for MWCs on univariate analysis included diabetes, tumors >10 cm, tumors <3 mm from skin surface, and vascularized flap/STSG closure. The same four variables were significant predictors on multivariable analysis. CONCLUSIONS: MWCs following preoperative RT and surgery were common. Tumor proximity to skin surface <3 mm is a previously unreported independent predictor, and further strategies to minimize wound complications are needed. More... »

PAGES

1494-1499

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-012-2797-1

DOI

http://dx.doi.org/10.1245/s10434-012-2797-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1011943930

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23242820


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