BACKGROUND AND OBJECTIVES: Preoperative radiation (PR) in the management of retroperitoneal sarcoma (RPS) is controversial. Concern for increased perioperative morbidity may influence the decision to recommend PR. Here we compare 30-day morbidity and mortality (M + M) after resection of RPS with and without PR. METHODS: Patients undergoing resection of RPS were identified using ACS NSQIP (2005-2011). Patients with known PR status within 90 days of operation were included. Univariate and multivariate logistic regression analyses were performed to identify factors associated with M + M. RESULTS: Of 696 patients operated on for RPS, 70 (10%) underwent PR. PR patients were younger (mean 55 vs. 61 years), more frequently had hypoalbuminemia (<3 g/dl; 19% vs. 10%), concomitant kidney (29% vs. 18%), or pancreas resections (11% vs. 5%), longer operations (mean 327 vs. 253 min), and increased transfusion requirements (mean 4.1 vs. 2.1 units, each P < 0.05). Despite these differences, the M + M rate (31% with vs. 30% without PR, P = 0.75) was comparable between the two groups. After adjustment for confounders, no association was identified between PR and M + M. CONCLUSIONS: In a national cohort of RPS patients, PR is infrequently utilized. Despite the increased prevalence of multiple risk factors, PR patients do not have an increased 30-day postoperative M + M.
BACKGROUND AND OBJECTIVES: Preoperative radiation (PR) in the management of retroperitoneal sarcoma (RPS) is controversial. Concern for increased perioperative morbidity may influence the decision to recommend PR. Here we compare 30-day morbidity and mortality (M + M) after resection of RPS with and without PR. METHODS:Patients undergoing resection of RPS were identified using ACS NSQIP (2005-2011). Patients with known PR status within 90 days of operation were included. Univariate and multivariate logistic regression analyses were performed to identify factors associated with M + M. RESULTS: Of 696 patients operated on for RPS, 70 (10%) underwent PR. PR patients were younger (mean 55 vs. 61 years), more frequently had hypoalbuminemia (<3 g/dl; 19% vs. 10%), concomitant kidney (29% vs. 18%), or pancreas resections (11% vs. 5%), longer operations (mean 327 vs. 253 min), and increased transfusion requirements (mean 4.1 vs. 2.1 units, each P < 0.05). Despite these differences, the M + M rate (31% with vs. 30% without PR, P = 0.75) was comparable between the two groups. After adjustment for confounders, no association was identified between PR and M + M. CONCLUSIONS: In a national cohort of RPS patients, PR is infrequently utilized. Despite the increased prevalence of multiple risk factors, PR patients do not have an increased 30-day postoperative M + M.
Authors: Daniel P Nussbaum; Paul J Speicher; Brian C Gulack; Asvin M Ganapathi; Brian R Englum; David G Kirsch; Douglas S Tyler; Dan G Blazer Journal: Ann Surg Date: 2015-07 Impact factor: 12.969
Authors: Daniel P Nussbaum; Paul J Speicher; Brian C Gulack; Asvin M Ganapathi; Jeffrey E Keenan; Sandra S Stinnett; David G Kirsch; Douglas S Tyler; Dan G Blazer Journal: Surg Oncol Date: 2014-07-23 Impact factor: 3.279
Authors: Falk Roeder; Alexis Ulrich; Gregor Habl; Matthias Uhl; Ladan Saleh-Ebrahimi; Peter E Huber; Daniela Schulz-Ertner; Anna V Nikoghosyan; Ingo Alldinger; Robert Krempien; Gunhild Mechtersheimer; Frank W Hensley; Juergen Debus; Marc Bischof Journal: BMC Cancer Date: 2014-08-27 Impact factor: 4.430