The risk of postoperative complications and functional impairment after multimodality treatment for limb and trunk wall soft-tissue sarcoma: Long term results from a monocentric series

Stoeckle, Eberhard; Michot, Audrey; Rigal, Laurent; Babre, F.; Sargos, P.; Figueiredo, B. Henriques de; Brouste, Véronique; Italiano, Antoîne; Toulmonde, Maud; Loarer, François Le; Kind, Michèle

doi:10.1016/j.ejso.2017.01.018

Cited by 18 publications

(13 citation statements)

References 32 publications

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“…The former study included adductor compartment sarcomas only, with a wound complication rate of 36%, while the latter study included patients with trunk STS as well as both upper and lower limb STS. 34 , 35 In addition, Davis et al reported that complications were related to worse functional outcome in patients with upper or lower extremity STS. 24 Interestingly, Slump et al reported that complications were associated with worse functional outcome in patients with upper extremity STS but not in patients with lower extremity STS.…”

Section: Discussionmentioning

confidence: 99%

Soft Tissue Sarcoma of Lower Extremity: Functional Outcome and Quality of Life

et al. 2021

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Background Few studies have focused on patient-related factors in analyzing long-term functional outcome and health-related quality of life (HRQoL) in patients with postoperative lower extremity soft tissue sarcoma (STS). Objective The purpose of this study was to investigate factors associated with postoperative functional outcome and HRQoL in patients with lower extremity STS. Methods This cross-sectional study was performed in a tertiary referral center using the Toronto Extremity Salvage Score (TESS), Quality-of-Life Questionnaire (QLQ)-C30 and 15 Dimension (15D) measures. Functional outcome and HRQoL data were collected prospectively. All patients were treated by a multidisciplinary team according to a written treatment protocol. Results A total of 141 patients who had undergone limb-salvage surgery were included. Depending on the outcome measure used, 19–51% of patients were completely asymptomatic and 13–14% of patients had an unimpaired HRQoL. The mean score for TESS, 15D mobility score, and QLQ-C30 Physical Functioning scale were 86, 0.83, and 75, respectively, while the mean score for 15D was 0.88, and 73 for QLQ-C30 QoL. Lower functional outcome was statistically significantly associated with higher age, higher body mass index (BMI), and the need for reconstructive surgery and radiotherapy, while lower HRQoL was statistically significantly associated with higher age, higher BMI, and reconstructive surgery. Conclusion Functional outcome and HRQoL were generally high in this cross-sectional study of patients with STS in the lower extremity. Both tumor- and treatment-related factors had an impact but patient-related factors such as age and BMI were the major determinants of both functional outcome and HRQoL.

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Section: Discussionmentioning

confidence: 99%

Soft Tissue Sarcoma of Lower Extremity: Functional Outcome and Quality of Life

et al. 2021

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“…Patients treated according to the ERAS protocol had lower rates of wound dehiscence and ileus and/or bowel obstruction, were less likely to be discharged to a facility, and had a shorter median hospital stay by 1 day. A previous study 10,11 of ERAS in the setting of STS showed that implementation of the protocol reduced hospital stay but with no significant reduction in major morbidity 11 . That study was limited to patients with extremity and trunk STS.…”

Section: Discussionmentioning

confidence: 98%

“…Although reducing wound complication rates is associated with administrative and cost benefits, there are potentially more significant clinical implications, particularly for patients with extremity STS. Better functional recovery is independently associated with implementation of ERAS protocols 11 . Currently, the standard of care for extremity STS is surgery combined with RT, which can be administered either before or after surgery 15 .…”

Section: Discussionmentioning

confidence: 99%

Enhanced recovery after surgery pathway in patients with soft tissue sarcoma

Lyu

Saadat

Bertagnolli

et al. 2020

British Journal of Surgery

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Background: Patients undergoing surgery for soft tissue sarcoma have high morbidity rates, particularly after preoperative radiation therapy (RT). An enhanced recovery after surgery (ERAS) programme may improve perioperative outcomes in abdominal surgery. This study reported outcomes of an ERAS programme tailored to patients with soft tissue sarcoma. Methods: A prospective ERAS protocol was implemented in 2015 at a high-volume sarcoma centre. Patients treated within the ERAS programme from 2015 to 2018 were case-matched retrospectively with patients treated between 2012 and 2018 without use of the protocol, matched by surgical site, surgeon, sarcoma histology and preoperative RT treatment. Postoperative outcomes, specifically wound complications and duration of hospital stay, were reported. Results: In total, 234 patients treated within the ERAS programme were matched with 237 who were not. The ERAS group had lower wound dehiscence rates overall (2 of 234 (0⋅9 per cent) versus 31 of 237 (13⋅1 per cent); P < 0⋅001), after preoperative RT (0 of 41 versus 11 of 51; P = 0⋅004) and after extremity sarcoma surgery (0 of 54 versus 6 of 56; P = 0⋅040) compared with the non-ERAS group. Rates of postoperative ileus or obstruction were lower in the ERAS group (21 of 234 (9⋅9 per cent) versus 40 of 237 (16⋅9 per cent); P = 0⋅016) and in those with retroperitoneal sarcoma (4 of 36 versus 15 of 36; P = 0⋅007). Duration of hospital stay was shorter in the ERAS group (median 5 (range 0-36) versus 6 (0-67) days; P = 0⋅003). Conclusion: Treatment within an ERAS protocol for patients with soft tissue sarcoma was associated with lower morbidity and shorter hospital stay.

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“…Although a small number of patients received neoadjuvant systemic therapy, an increased incidence of post-operative wound complications was seen in this group compared to those that did not receive chemotherapy (50% vs. 13.6%), which trended towards significance (p=0.07). Other studies that have assessed the impact of neoadjuvant chemotherapy in patients treated with conventionally fractioned radiation have, for the most part, not been associated with an increased incidence of post-operative wound complication (32)(33)(34).…”

Section: Discussionmentioning

confidence: 99%

“…Other studies that have assessed the impact of neoadjuvant chemotherapy in patients treated with conventionally fractioned irradiation have, for the most part, not been associated with an increased incidence of postoperative wound complications. 32 , 33 , 34 …”

Section: Discussionmentioning

confidence: 99%

Is 5 the New 25? Long-Term Oncologic Outcomes From a Phase II, Prospective, 5-Fraction Preoperative Radiation Therapy Trial in Patients With Localized Soft Tissue Sarcoma

Bedi¹,

Singh²,

Charlson³

et al. 2022

Advances in Radiation Oncology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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The risk of postoperative complications and functional impairment after multimodality treatment for limb and trunk wall soft-tissue sarcoma: Long term results from a monocentric series

Cited by 18 publications

References 32 publications

Soft Tissue Sarcoma of Lower Extremity: Functional Outcome and Quality of Life

Soft Tissue Sarcoma of Lower Extremity: Functional Outcome and Quality of Life

Enhanced recovery after surgery pathway in patients with soft tissue sarcoma

Is 5 the New 25? Long-Term Oncologic Outcomes From a Phase II, Prospective, 5-Fraction Preoperative Radiation Therapy Trial in Patients With Localized Soft Tissue Sarcoma

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