Predictors of Wound Complications following Radiation and Surgical Resection of Soft Tissue Sarcomas

Wound complications represent a major source of morbidity in patients undergoing radiation therapy (RT) and surgical resection of soft tissue sarcomas (STS). We investigated whether factors related to RT, surgery, patient comorbidities, and tumor histopathology predict the development of wound compl...

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Main Authors: Drake G. LeBrun, David M. Guttmann, Jacob E. Shabason, William P. Levin, Stephen J. Kovach, Kristy L. Weber
Format: Article
Language:English
Published: Hindawi Limited 2017-01-01
Series:Sarcoma
Online Access:http://dx.doi.org/10.1155/2017/5465130
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spelling doaj-c9b3d2c6f3e74272b9d704a75fdb28d62020-11-24T21:01:33ZengHindawi LimitedSarcoma1357-714X1369-16432017-01-01201710.1155/2017/54651305465130Predictors of Wound Complications following Radiation and Surgical Resection of Soft Tissue SarcomasDrake G. LeBrun0David M. Guttmann1Jacob E. Shabason2William P. Levin3Stephen J. Kovach4Kristy L. Weber5Perelman School of Medicine, University of Pennsylvania, Jordan Medical Education Center, 3400 Civic Center Blvd., Philadelphia, PA 19104, USADepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, TRC 2 West, Philadelphia, PA 19104, USADepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, TRC 2 West, Philadelphia, PA 19104, USADepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, TRC 2 West, Philadelphia, PA 19104, USADepartment of Plastic Surgery, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 7th Floor South Pavilion, Philadelphia, PA 19104, USADepartment of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, 10-179 South Pavilion, Philadelphia, PA 19104, USAWound complications represent a major source of morbidity in patients undergoing radiation therapy (RT) and surgical resection of soft tissue sarcomas (STS). We investigated whether factors related to RT, surgery, patient comorbidities, and tumor histopathology predict the development of wound complications. An observational study of patients who underwent STS resection and RT was performed. The primary outcome was the occurrence of any wound complication up to four months postoperatively. Significant predictors of wound complications were identified using multivariable logistic regression. Sixty-five patients representing 67 cases of STS were identified. Median age was 59 years (range 22–90) and 34 (52%) patients were female. The rates of major wound complications and any wound complications were 21% and 33%, respectively. After adjusting for radiation timing, diabetes (OR 9.6; 95% CI 1.4–64.8; P=0.02), grade ≥2 radiation dermatitis (OR 4.8; 95% CI 1.2–19.2; P=0.03), and the use of 3D conformal RT (OR 4.6; 95% CI 1.1–20.0; P=0.04) were associated with an increased risk of any wound complication on multivariable analysis. These data suggest that radiation dermatitis and radiation modality are predictors of wound complications in patients with STS.http://dx.doi.org/10.1155/2017/5465130
collection DOAJ
language English
format Article
sources DOAJ
author Drake G. LeBrun
David M. Guttmann
Jacob E. Shabason
William P. Levin
Stephen J. Kovach
Kristy L. Weber
spellingShingle Drake G. LeBrun
David M. Guttmann
Jacob E. Shabason
William P. Levin
Stephen J. Kovach
Kristy L. Weber
Predictors of Wound Complications following Radiation and Surgical Resection of Soft Tissue Sarcomas
Sarcoma
author_facet Drake G. LeBrun
David M. Guttmann
Jacob E. Shabason
William P. Levin
Stephen J. Kovach
Kristy L. Weber
author_sort Drake G. LeBrun
title Predictors of Wound Complications following Radiation and Surgical Resection of Soft Tissue Sarcomas
title_short Predictors of Wound Complications following Radiation and Surgical Resection of Soft Tissue Sarcomas
title_full Predictors of Wound Complications following Radiation and Surgical Resection of Soft Tissue Sarcomas
title_fullStr Predictors of Wound Complications following Radiation and Surgical Resection of Soft Tissue Sarcomas
title_full_unstemmed Predictors of Wound Complications following Radiation and Surgical Resection of Soft Tissue Sarcomas
title_sort predictors of wound complications following radiation and surgical resection of soft tissue sarcomas
publisher Hindawi Limited
series Sarcoma
issn 1357-714X
1369-1643
publishDate 2017-01-01
description Wound complications represent a major source of morbidity in patients undergoing radiation therapy (RT) and surgical resection of soft tissue sarcomas (STS). We investigated whether factors related to RT, surgery, patient comorbidities, and tumor histopathology predict the development of wound complications. An observational study of patients who underwent STS resection and RT was performed. The primary outcome was the occurrence of any wound complication up to four months postoperatively. Significant predictors of wound complications were identified using multivariable logistic regression. Sixty-five patients representing 67 cases of STS were identified. Median age was 59 years (range 22–90) and 34 (52%) patients were female. The rates of major wound complications and any wound complications were 21% and 33%, respectively. After adjusting for radiation timing, diabetes (OR 9.6; 95% CI 1.4–64.8; P=0.02), grade ≥2 radiation dermatitis (OR 4.8; 95% CI 1.2–19.2; P=0.03), and the use of 3D conformal RT (OR 4.6; 95% CI 1.1–20.0; P=0.04) were associated with an increased risk of any wound complication on multivariable analysis. These data suggest that radiation dermatitis and radiation modality are predictors of wound complications in patients with STS.
url http://dx.doi.org/10.1155/2017/5465130
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