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Ziegele M, King DM, Bedi M. Tumor volume is a better predictor of post-operative wound complications compared to tumor size in soft tissue sarcomas of the proximal lower extremity. Clin Sarcoma Res. 2016;6:1doi: 10.1186/s13569-016-0041-7.
Ziegele, M., King, D. M., & Bedi, M. (2016). Tumor volume is a better predictor of post-operative wound complications compared to tumor size in soft tissue sarcomas of the proximal lower extremity. Clinical sarcoma research, 61. https://doi.org/10.1186/s13569-016-0041-7
Ziegele, Michael, et al. "Tumor volume is a better predictor of post-operative wound complications compared to tumor size in soft tissue sarcomas of the proximal lower extremity." Clinical sarcoma research vol. 6 (2016): 1. doi: https://doi.org/10.1186/s13569-016-0041-7
Ziegele M, King DM, Bedi M. Tumor volume is a better predictor of post-operative wound complications compared to tumor size in soft tissue sarcomas of the proximal lower extremity. Clin Sarcoma Res. 2016 Feb 22;6:1. doi: 10.1186/s13569-016-0041-7. eCollection 2016. PMID: 26909140; PMCID: PMC4763425.
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Clin Sarcoma Res. 2016 Feb 22;6:1. doi: 10.1186/s13569-016-0041-7. eCollection 2016.

Tumor volume is a better predictor of post-operative wound complications compared to tumor size in soft tissue sarcomas of the proximal lower extremity.

Clinical sarcoma research

Michael Ziegele, David M King, Manpreet Bedi

Affiliations

  1. Department of Orthopaedic Surgery, Medical College of Wisconsin, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA.
  2. Department of Radiation Oncology, Medical College of Wisconsin, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA.

PMID: 26909140 PMCID: PMC4763425 DOI: 10.1186/s13569-016-0041-7

Abstract

BACKGROUND: Wide local excision with or without radiation therapy (RT) and chemotherapy is widely accepted as appropriate management for soft tissue sarcomas (STS) of the extremity. Although survival and local control rates are comparable to amputation, post-operative wound complications (WC) following limb salvage can result in significant morbidity for the patient. Certain risk factors such as location, pre-operative RT, and age have been shown to increase the risk of WCs. Somewhat surprisingly, size has not consistently been shown to impact WC rates. The goal of this study is to assess whether tumor volume, as opposed to the traditional measurement of the largest dimension in one plane, correlates with the development of post-operative WCs.

METHODS: Between 2000 and 2013, 81 patients with STS of the proximal lower extremity, buttock and pelvis were retrospectively identified from our prospective database. We reviewed the impact of patient, tumor, and treatment variables on postoperative WC. Predictors for WC were evaluated using the Fisher exact test for univariate analysis and logistic regression for multivariate analysis. Tumor volume was determined using the medical image merge (MIM) (®) software program (version 6.5.4, MIM Software, Cleveland, OH). Tumor size (diameter) was determined the historical way of measuring the widest dimension on the sagittal, coronal, and axial planes from the MRI scan at midplane.

RESULTS: The overall WC rate within 6 months of tumor resection was 32 %. WC were more likely to occur with larger tumor volumes (p = 0.015), although not with tumor diameters ≥10 cm (p = 0.55). Neither volume of subcutaneous fat (p = 0.34) or depth of the subcutaneous fat layer (p = 0.82) significantly impacted WC rates. Tumor proximity to skin surface also did not significantly impact WC risk (p = 0.73).

CONCLUSIONS: Increase in tumor volume led to a higher risk of post-operative WCs. Assessing tumor volume may allow clinicians to better counsel patients on their risk of post-operative WCs. Tumor volume, as opposed to size alone, should be considered in future sarcoma outcome studies.

References

  1. Semin Surg Oncol. 1994 Sep-Oct;10(5):347-56 - PubMed
  2. Ann Surg Oncol. 2016 Feb;23 Suppl 2:S236-41 - PubMed
  3. Dig Surg. 2010;27(4):331-5 - PubMed
  4. CA Cancer J Clin. 2005 Jan-Feb;55(1):10-30 - PubMed
  5. Eur J Surg Oncol. 2014 Dec;40(12):1671-6 - PubMed
  6. Ann Surg Oncol. 2015 Sep;22(9):2824-30 - PubMed
  7. Clin Orthop Relat Res. 2007 Jun;459:182-5 - PubMed
  8. Int J Radiat Oncol Biol Phys. 2012 Feb 1;82(2):933-9 - PubMed
  9. Clin Orthop Relat Res. 2013 Nov;471(11):3612-7 - PubMed
  10. Ann Surg Oncol. 2013 May;20(5):1494-9 - PubMed
  11. Am Surg. 2004 Apr;70(4):347-51 - PubMed
  12. Lancet. 2002 Jun 29;359(9325):2235-41 - PubMed
  13. J Dent Res. 2010 Mar;89(3):219-29 - PubMed
  14. Sarcoma. 2010;2010:829498 - PubMed
  15. Am J Obstet Gynecol. 1995 Aug;173(2):465-9; discussion 469-71 - PubMed
  16. J Bone Joint Surg Am. 2013 Feb 20;95(4):323-8 - PubMed
  17. Plast Reconstr Surg. 1994 Apr;93(5):980-7 - PubMed
  18. Eur J Surg Oncol. 2002 Feb;28(1):75-9 - PubMed
  19. J Clin Oncol. 1987 Mar;5(3):480-8 - PubMed
  20. Cancer. 2006 Nov 15;107(10):2455-61 - PubMed
  21. J Clin Oncol. 1998 Jan;16(1):197-203 - PubMed
  22. Gastric Cancer. 2012 Apr;15(2):206-12 - PubMed

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