Obesity is associated with larger soft‐tissue sarcomas, more surgical complications, and more complex wound closures (obesity leads to larger soft‐tissue sarcomas)

Montgomery, Corey; Harris, John; Siegel, Eric R.; Suva, Larry J.; Wilson, Mark; Morell, Sean; Nicholas, Richard W.

doi:10.1002/jso.25119

Cited by 17 publications

(10 citation statements)

References 33 publications

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“…The rate of all complications including CD-grade 1 in our cohort of soft tissue sarcomas of the chest wall with 44% was comparable to a study of Slump et al on STS of various locations that required flap coverage and Montgomery et al on extremity STS [25,26].…”

Section: Discussionsupporting

confidence: 86%

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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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Section: Discussionsupporting

confidence: 86%

“…In univariate analysis, obesity was associated with higher wound complications in our cohort. Accordingly, Montgomery et al found obesity to be associated with both a larger tumor size and higher morbidity as causes of wound complications, and thus that it is eliminated by other factors in multivariate analysis [26].…”

Section: Discussionmentioning

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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“…Even though the levels of these complication rates are in accordance with the literature, all efforts should be made to further decrease those levels. However, the risk of such major complications may not only be related RT, but possibly even more to the patient [20] and individual tumor characteristics [21] and tumor specific molecular mechanisms [22, 23]. In addition, different surgical resection modes (wide excision or compartment resection in contrast to simple resection [24]), differences in preoperative treatments, and various localizations (maybe affecting of neurovascular structures bones or joints) of soft tissue sarcomas may play a role in major complication rates.…”

Section: Discussionmentioning

confidence: 99%

Patient’s quality of life after surgery and radiotherapy for extremity soft tissue sarcoma - a retrospective single-center study over ten years

Götzl

Sterzinger

Semrau

et al. 2019

Health Qual Life Outcomes

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Background and objectivesThe purpose of this study is to analyze major complication rates and different aspects of health-related quality of life (HRQoL) in extremity soft tissue sarcoma (STS) patients treated with or without radio (chemo) therapy and surgery.MethodsWe performed a retrospective analysis of all patients who underwent Extremity STS excision from 2004 to 2014 (182 patients included). Patients’ data were collected from patients’ records. HRQoL was assessed by using EORTC QLQ-C30.ResultsA total of 182 patients underwent sarcoma resection. After neoadjuvant radiochemotherapy (RCT), the major-complication rate amounted to 28% (vs. 7%, no radiotherapy, p < 0.001). Major-complication rates after adjuvant radiotherapy (RT) occurred in 8% (vs. 7%, no radiotherapy, p = 0.265). Comparison QoL scores between treating with neoadjuvant RCT or without RT revealed significant worse scores with neoadjuvant RCT. Further stratification of disease control of these patients showed significant reduced scores in the group of disease-free patients with neoadjuvant RCT compared to irradiated disease-free patients.DiscussionTo date, there have only been a few investigations of QoL in STS. Retrospective study on quality of life have limitations, like a lack of baseline evaluation of QoL. Patient candidated to radiation therapy could have had worse QoL baseline due to more advanced disease. Disease status of the patients who answered the questionnaires could have been an influence of QoL and we could show reduced scores in the group of disease-free patients with neoadjuvant RCT, but not for the patients with recurrence or metastasis, so it is very hard to discriminate whether radiation therapy could really have an impact or not.ConclusionThis study might assist in further improving the understanding of QoL in STS patients and may animate for prospective studies examining the oncological therapies impact on HRQoL.

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“…49,50 In adults, the association between obesity and multiple complications such as impaired or totally EDITORIAL failed cutaneous wound healing, particularly following surgery, has been identified by various groups. [51][52][53][54][55][56][57][58][59][60] Being overweight or obese significantly increases the likelihood of infection-related complications compared with those within a healthy weight range. 61 There are many factors that contribute to the chronicity of infection in obese people.…”

Section: Overweight and Obesitymentioning

confidence: 99%

Human Wounds and Its Burden: An Updated Compendium of Estimates

Sen

2019

Advances in Wound Care

790

559

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A 2018 retrospective analysis of Medicare beneficiaries identified that *8.2 million people had wounds with or without infections. Medicare cost estimates for acute and chronic wound treatments ranged from $28.1 billion to $96.8 billion. Highest expenses were for surgical wounds followed by diabetic foot ulcers, with a higher trend toward costs associated with outpatient wound care compared with inpatient. Increasing costs of health care, an aging population, recognition of difficult-to-treat infection threats such as biofilms, and the continued threat of diabetes and obesity worldwide make chronic wounds a substantial clinical, social, and economic challenge. Recent Advances: Chronic wounds are not a problem in an otherwise healthy population. Underlying conditions ranging from malnutrition, to stress, to metabolic syndrome, predispose patients to chronic, nonhealing wounds. From an economic point of view, the annual wound care products market is expected to reach $15-22 billion by 2024. The National Institutes of Health's (NIH) Research Portfolio Online Reporting Tool (RePORT) now lists wounds as a category. Future Directions: A continued rise in the economic, clinical, and social impact of wounds warrants a more structured approach and proportionate investment in wound care, education, and related research.

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Obesity is associated with larger soft‐tissue sarcomas, more surgical complications, and more complex wound closures (obesity leads to larger soft‐tissue sarcomas)

Abstract: These findings suggest that obesity is associated with larger tumors, a higher incidence of wound complications, and greater use of complex wound-closure methods.

Cited by 17 publications

References 33 publications

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

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

Patient’s quality of life after surgery and radiotherapy for extremity soft tissue sarcoma - a retrospective single-center study over ten years

Human Wounds and Its Burden: An Updated Compendium of Estimates

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