Rebekka Götzl1,2, Sebastian Sterzinger1, Andreas Arkudas1, Anja M Boos1,2, Sabine Semrau3, Nikolaos Vassos4,5, Robert Grützmann4, Abbas Agaimy6, Werner Hohenberger4, Raymund E Horch1, Justus P Beier1,2. 1. Department of Plastic and Hand Surgery, Comprehensive Cancer Center, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany. 2. Department of Plastic Surgery, Hand and Burn Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany. 3. Department of Radiation Oncology, Comprehensive Cancer Center, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany. 4. Department of Surgery, Comprehensive Cancer Center, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany. 5. Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, University Medical Center Mannheim, University of Heidelberg, 69117 Mannheim, Germany. 6. Department of Pathology, Comprehensive Cancer Center, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
Abstract
BACKGROUND: Soft tissue sarcoma (STS) treatment is an interdisciplinary challenge. Along with radio(chemo)therapy, surgery plays the central role in STS treatment. Little is known about the impact of reconstructive surgery on STS, particularly whether reconstructive surgery enhances STS resection success with the usage of flaps. Here, we analyzed the 10-year experience at a university hospital's Comprehensive Cancer Center, focusing on the role of reconstructive surgery. METHODS: We performed a retrospective analysis of STS-patients over 10 years. We investigated patient demographics, diagnosis, surgical management, tissue/function reconstruction, complication rates, resection status, local recurrence and survival. RESULTS: Analysis of 290 patients showed an association between clear surgical margin (R0) resections and higher-grade sarcoma in patients with free flaps. Major complications were lower with primary wound closure than with flaps. Comparison of reconstruction techniques showed no significant differences in complication rates. Wound healing was impaired in STS recurrence. The local recurrence risk was over two times higher with primary wound closure than with flaps. CONCLUSION: Defect reconstructions in STS are reliable and safe. Plastic surgeons should have a permanent place in interdisciplinary surgical STS treatment, with the full armamentarium of reconstruction methods.
BACKGROUND: Soft tissue sarcoma (STS) treatment is an interdisciplinary challenge. Along with radio(chemo)therapy, surgery plays the central role in STS treatment. Little is known about the impact of reconstructive surgery on STS, particularly whether reconstructive surgery enhances STS resection success with the usage of flaps. Here, we analyzed the 10-year experience at a university hospital's Comprehensive Cancer Center, focusing on the role of reconstructive surgery. METHODS: We performed a retrospective analysis of STS-patients over 10 years. We investigated patient demographics, diagnosis, surgical management, tissue/function reconstruction, complication rates, resection status, local recurrence and survival. RESULTS: Analysis of 290 patients showed an association between clear surgical margin (R0) resections and higher-grade sarcoma in patients with free flaps. Major complications were lower with primary wound closure than with flaps. Comparison of reconstruction techniques showed no significant differences in complication rates. Wound healing was impaired in STS recurrence. The local recurrence risk was over two times higher with primary wound closure than with flaps. CONCLUSION: Defect reconstructions in STS are reliable and safe. Plastic surgeons should have a permanent place in interdisciplinary surgical STS treatment, with the full armamentarium of reconstruction methods.
Authors: Sarah M Elswick; Peter Wu; Arya A Arkhavan; Vanessa E Molinar; Anita T Mohan; Frank H Sim; Jorys Martinez-Jorge; Michel Saint-Cyr Journal: J Plast Reconstr Aesthet Surg Date: 2019-05-16 Impact factor: 2.740
Authors: Kenneth R Gundle; Sanjay Gupta; Lisa Kafchinski; Anthony M Griffin; Rita A Kandel; Brendan C Dickson; Peter W Chung; Charles N Catton; Brian O'Sullivan; Peter C Ferguson; Jay S Wunder Journal: Ann Surg Oncol Date: 2017-03-27 Impact factor: 5.344
Authors: Jelena Slump; Stefan O P Hofer; Peter C Ferguson; Jay S Wunder; Anthony M Griffin; Harald J Hoekstra; Esther Bastiaannet; Anne C O'Neill Journal: Eur J Surg Oncol Date: 2017-11-26 Impact factor: 4.424
Authors: Joshua M Lawrenz; Nathan W Mesko; Danielle C Marshall; Joseph Featherall; Jaiben George; Jaymeson Gordon; Aparna Vijayasekaran; Lukas M Nystrom; Graham S Schwarz Journal: Ann Plast Surg Date: 2020-08 Impact factor: 1.539
Authors: Gunar K Zagars; Matthew T Ballo; Peter W T Pisters; Raphael E Pollock; Shreyaskumar R Patel; Robert S Benjamin; Harry L Evans Journal: Cancer Date: 2003-05-15 Impact factor: 6.860
Authors: Patrick W O'Donnell; Anthony M Griffin; William C Eward; Amir Sternheim; Charles N Catton; Peter W Chung; Brian O'Sullivan; Peter C Ferguson; Jay S Wunder Journal: Cancer Date: 2014-06-03 Impact factor: 6.860
Authors: Mohamedtaki A Tejani; Thomas J Galloway; Miriam Lango; John A Ridge; Margaret von Mehren Journal: Cancers (Basel) Date: 2013-07-15 Impact factor: 6.639
Authors: Rebekka Götzl; Sebastian Sterzinger; Sabine Semrau; Nikolaos Vassos; Werner Hohenberger; Robert Grützmann; Abbas Agaimy; Andreas Arkudas; Raymund E Horch; Justus P Beier Journal: Health Qual Life Outcomes Date: 2019-11-08 Impact factor: 3.186
Authors: Benjamin Thomas; Amir K Bigdeli; Steffen Nolte; Emre Gazyakan; Leila Harhaus; Oliver Bischel; Burkhard Lehner; Gerlinde Egerer; Gunhild Mechtersheimer; Peter Hohenberger; Raymund E Horch; Dimosthenis Andreou; Jochen Schmitt; Markus K Schuler; Martin Eichler; Ulrich Kneser Journal: Cancers (Basel) Date: 2022-09-02 Impact factor: 6.575