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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2015

01-09-2015 | Bone and Soft Tissue Sarcomas

The Influence of Time Interval Between Preoperative Radiation and Surgical Resection on the Development of Wound Healing Complications in Extremity Soft Tissue Sarcoma

Authors: Anthony M. Griffin, MSc, Colleen I. Dickie, MSc, Charles N. Catton, MD, FRCPC, Peter W. M. Chung, MD, FRCPC, Peter C. Ferguson, MD, FRCSC, Jay S. Wunder, MD, FRCSC, Brian O’Sullivan, MD, FRCPC

Published in: Annals of Surgical Oncology | Issue 9/2015

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Abstract

Objective

The aim of this study was to determine the relationship of the time interval between completion of preoperative radiation therapy (RT) and surgical resection on wound complications (WCs) in extremity soft tissue sarcoma (STS).

Methods

Overall, 798 extremity STS patients were managed with preoperative RT and surgery from 1989 to 2013. WCs were defined as requiring secondary operations/invasive procedures for wound care, use of vacuum-assisted closure, prolonged dressing changes, or infection within 120 days of surgery.

Results

Mean tumor size was 8.8 cm. A total of 743 (93 %) tumors were primary presentations, 565 (71 %) patients had lower extremity tumors, and 238 patients (30 %) had a prior unplanned excision. Of 242 patients (30 %) who developed a WC, 206 (37 %) had lower extremity tumors and 36 (15 %) had upper extremity tumors. Mean time from RT completion to surgery was 41.3 (range 4–470) days; 42.0 (range 4–470) days for upper extremity cases, and 41.1 (range 4–109) days for lower extremity cases. Similarly, mean time interval for patients who developed a WC was 40.9 (range 4–100) days, and 41.5 (range 4–470) days for those who did not develop a WC (p = 0.69). Thirty-nine cases (5 %) had surgery within 3 weeks of RT; 15 (38 %) patients developed WCs versus 227 (30 %) patients who had their tumors excised after 3 weeks (p = 0.28). One hundred and twenty-nine (16 %) patients had surgery within 4 weeks, and 39 (30 %) patients developed WCs versus 203 (30 %) patients who had their tumors excised after 4 weeks (p = 1.0). A trend towards a higher rate of WCs was seen for those patients who had surgery after 6 weeks (28 % prior vs. 34 % after; p = 0.08). There was no difference in WCs with intensity-modulated RT (IMRT) versus non-IMRT cases (p = 0.6).

Conclusion

The time interval between preoperative RT and surgical excision in extremity STS had minimal influence on the development of WCs. Four- or 5-week intervals showed equivalent complication rates between the two groups, suggesting an optimal interval to reduce potential WCs.
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Metadata
Title
The Influence of Time Interval Between Preoperative Radiation and Surgical Resection on the Development of Wound Healing Complications in Extremity Soft Tissue Sarcoma
Authors
Anthony M. Griffin, MSc
Colleen I. Dickie, MSc
Charles N. Catton, MD, FRCPC
Peter W. M. Chung, MD, FRCPC
Peter C. Ferguson, MD, FRCSC
Jay S. Wunder, MD, FRCSC
Brian O’Sullivan, MD, FRCPC
Publication date
01-09-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 9/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4631-z

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