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

01-09-2015 | Bone and Soft Tissue Sarcomas

Quality of Life, Functional Outcomes, and Wound Complications in Patients with Soft Tissue Sarcomas Treated with Preoperative Chemoradiation: A Prospective Study

Authors: Justin D. Rivard, MD, Shannon S. Puloski, MD, Walley J. Temple, MD, Allison Fyfe, RN, Michael Kwan, MD, Norman Schachar, MD, Elizabeth Kurien, MD, Kathryn Lanuke, MD, Lloyd A. Mack, MD

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

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Abstract

Background

Preoperative irradiation reduces local recurrence of soft tissue sarcomas (STSs), but major wound complication rates approach 25–35 %. Using a novel neoadjuvant chemoradiation protocol, we prospectively documented functional outcomes and quality of life (QOL) and hypothesized a lower major wound complication rate.

Methods

Patients with STS deep to muscular fascia were treated with 3 days of doxorubicin (30 mg/day) and 10 days of irradiation (300 cGy/day) followed by limb-sparing surgery. Wound complications were assessed, and functional assessment and QOL were followed prospectively using the Toronto Extremity Salvage Score (TESS), Musculoskeletal Tumor Society (MSTS), and Short Form (SF)-36 questionnaires preoperatively and 6 and 12 months postoperatively.

Results

Altogether, 52 consecutive patients were accrued during 2006–2011. Overall, 80.8 % of STSs were >5 cm, and 67.3 % involved the lower extremity. Seven (13.5 %) major wound complications occurred, all requiring reoperation. Preoperative scores for TESS, MSTS, and SF-36 physical (PCS) and mental (MCS) health components were 83.3, 86.7, 40.6, and 49.4, respectively. There were no differences seen 6 months postoperatively. By 12 months, however, patients showed improved functional scores (TESS 93.0, p = 0.02; MSTS 93.3, p < 0.01) and QOL scores (PCS 45.1, p = 0.02; MCS = 52.9, p = 0.05). No differences in scores were seen between patients with or without wound complications.

Conclusions

Patients treated with our neoadjuvant chemoradiation protocol had stable QOL and functional scores 6 months postoperatively and showed improvement by 12 months. Importantly, the major wound complication rate was low.
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Metadata
Title
Quality of Life, Functional Outcomes, and Wound Complications in Patients with Soft Tissue Sarcomas Treated with Preoperative Chemoradiation: A Prospective Study
Authors
Justin D. Rivard, MD
Shannon S. Puloski, MD
Walley J. Temple, MD
Allison Fyfe, RN
Michael Kwan, MD
Norman Schachar, MD
Elizabeth Kurien, MD
Kathryn Lanuke, MD
Lloyd A. Mack, MD
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/s10434-015-4490-7

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