Evidence map›Paper›PMID 38520583›Full record

ArticleAnnals of surgical oncology2024

Sarcoma Size and Limb Dimensions Predict Complications, Recurrence, and Death in Patients with Soft Tissue Sarcoma in the Thigh: A Multidimensional Analysis.

Rami Elmorsi, Luis Camacho, David D Krijgh, Gordon S Tilney, Heather Lyu, Raymond S Traweek, Russell G Witt, Margaret S Roubaud, Christina L Roland, Alexander F Mericli

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Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

10 authors.

Rami ElmorsiDepartment of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Luis CamachoDepartment of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
David D KrijghDepartment of Plastic, Reconstructive, and Hand Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Gordon S TilneyDepartment of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Heather LyuDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Raymond S TraweekDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Russell G WittDepartment of Surgery, University of Virginia, Charlottesville, VA, USA.
Margaret S RoubaudDepartment of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Christina L RolandDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Alexander F MericliDepartment of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. AFMericli@mdanderson.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLimb-sparing resections of thigh soft tissue sarcomas (STSs) can result in adverse outcomes. Identifying preoperative predictors for wound healing complications, tumor recurrence, and mortality is crucial for informed reconstructive decision-making. We hypothesized that preoperative measurements of thigh and tumor dimensions could serve as reliable indicators for postoperative complications, recurrence, and death. PATIENTS AND

methodsIn this retrospective cohort study conducted from March 2016 to December 2021, we analyzed patients undergoing thigh STS excisions followed by reconstruction. Preoperative magnetic resonance imaging or computed tomography scans provided necessary thigh and tumor dimensions. Univariate and multivariate regression assessed relationships between these dimensions and postoperative outcomes, including complications, recurrence, and death.

resultsUpon the analysis of 123 thighs, we found thigh width to be highly predictive of postoperative complications, even surpassing body mass index (BMI) and retaining significance in multivariate regression [odds ratio (OR) 1.19; 95% CI 1.03-1.39; p = 0.03]. Sarcoma-to-thigh width and thickness ratios predicted STS recurrence, with the thickness ratio retaining significance in multivariate regression (OR 1.03; 95% CI 1.001-1.05; p = 0.041). Notably, greater thigh thickness was independently protective against mortality in multivariate analysis (OR 0.80; 95% CI 0.65-0.98; p = 0.030).

conclusionsThigh width outperformed BMI in association with postoperative complications. This may create an opportunity for intervention, where weight loss can play a role during the neoadjuvant therapy period to potentially reduce complications. Sarcoma-to-thigh width and thickness ratios, particularly the latter, hold substantial predictive value in terms of STS recurrence. Moreover, thigh thickness is an independent predictor of survival.

Indexed as

Neoplasm Recurrence, LocalPostoperative ComplicationsSarcomaThighAdultAgedFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedPlastic Surgery ProceduresPrognosisRetrospective StudiesSoft Tissue NeoplasmsDimensionsFree flapOutcomesPlastic surgerySoft tissue sarcomaSurgical flapsSurgical oncologyWound healing

Identifiers

PMID38520583

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