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CC BY 4.0 · Brazilian Journal of Oncology 2020; 16: e-20200014
DOI: 10.5935/2526-8732.20200014
Original Article
Oncological Surgery

Morbimortality related to the treatment of the soft tissue sarcomas

Morbimortalidade relacionada ao tratamento dos sarcomas de tecidos moles

Letícia Maria Modes Costa Scofoni
1   Barretos School Of Health Sciences, Dr. Paulo Prata, Medicine - Barretos - Sao Paulo - Brazil
,
Carlos Eduardo Barbosa de Carvalho
2   Barretos Cancer Hospital, Department of Surgery, Melanoma, Sarcoma and Mesenchymal tumors -Barretos - Sao Paulo - Brazil
,
Caio Pereira
3   Barretos Cancer Hospital, Department of Clinical Oncology - Barretos - Sao Paulo - Brazil
,
Sergio Vicente Serrano
3   Barretos Cancer Hospital, Department of Clinical Oncology - Barretos - Sao Paulo - Brazil
,
Vinicius de Lima Vazquez
2   Barretos Cancer Hospital, Department of Surgery, Melanoma, Sarcoma and Mesenchymal tumors -Barretos - Sao Paulo - Brazil
› Author Affiliations Financial support: The authors would like to express their sincere thanks to the São Paulo Research Foundation (FAPESP) for its funding of this research (Costa's Fellowship Grant #2017/02437-8).
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ABSTRACT

Objective: To characterize patients with soft tissue sarcoma in their demographic, clinical, histopathological and treatment aspects, treatment toxicity, and postoperative complications occurring within 30 days of the first surgery. Methods: A retrospective cohort study with clinical data collection and referring to the treatment of patients with soft tissue sarcomas, obtained through patients records from January to December 2017. The main focus was the analysis of the data of acute morbimortality related to the patient and tumor, graded by CTCAE (Common Terminology Criteria for Adverse Events). For this, we use data from a single tertiary institution leading the treatment of cancer in Brazil. Results: There was a higher prevalence of localization of sarcomas in extremities. The initial treatment is usually total excision, the number of postoperative complications was high (29.3%), such as signs of infection, surgical wound dehiscence, seroma formation, among others. Morbidities requiring hospitalization within 30 days of initiation of treatment were observed in 6 patients (9.84%), the majority with treatment or disease-related cause. The occurrence of death up to 30 postoperative days or up to 3 cycles of systemic therapy was not observed. Conclusion: Despite a high morbidity rate, much of it was mild and not associated with mortality. The study of the sarcoma-bearing population makes it possible to create realistic treatment strategies, as well as the use of the database for future research.

RESUMO

Objetivo: Para caracterizar os pacientes com sarcoma de tecidos moles em seus aspectos demográficos, clínicos, histopatológicos e de tratamento, toxicidade do tratamento e complicações pós-operatórias que ocorrem dentro de 30 dias após a primeira cirurgia. Métodos: Estudo de coorte retrospectivo, com coleta de dados clínicos e referente ao tratamento de pacientes com sarcomas de tecidos moles, obtido através de prontuários de janeiro a dezembro de 2017. O foco principal foi a análise dos dados de morbimortalidades agudas relacionadas ao paciente e tumor, classificado pelo CTCAE (Critérios Comuns de Terminologia para Eventos Adversos). Para isso, usamos dados de uma única instituição terciária que lidera o tratamento do câncer no Brasil. Resultados: Houve maior prevalência de localização de sarcomas nas extremidades. O tratamento inicial é geralmente a excisão total, o número de complicações pós-operatórias foi alto (29,3%), como sinais de infecção, deiscência de ferida operatória, formação de seroma, entre outros. Foram observadas morbidades em 6 pacientes que necessitaram de hospitalização dentro de 30 dias do início do tratamento (9,84%), a maioria com tratamento ou causa relacionada à doença. Não foi observada ocorrência de óbito até 30 dias de pós-operatório ou até 3 ciclos de terapia sistêmica. Conclusão: Apesar da alta taxa de morbidade, grande parte foi leve e não associada à mortalidade. O estudo da população portadora de sarcoma possibilita a criação de estratégias de tratamento realistas, bem como o uso do banco de dados para pesquisas futuras.

Keywords:

Sarcoma - Indicators of morbidity and mortality - Toxicity - Postoperative complications

Descritores:

Sarcoma - Indicadores de morbidade e mortalidade - Toxicidade - Complicações pós-operatórias


Publication History

Received: 02 April 2019

Accepted: 14 February 2020

Article published online:
02 July 2020

© 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Bibliographical Record
Letícia Maria Modes Costa Scofoni, Carlos Eduardo Barbosa de Carvalho, Caio Pereira, Sergio Vicente Serrano, Vinicius de Lima Vazquez. Morbimortality related to the treatment of the soft tissue sarcomas. Brazilian Journal of Oncology 2020; 16: e-20200014.
DOI: 10.5935/2526-8732.20200014
 

  • REFERENCES

  • Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA: Cancer J Clin 2014; Jan/Feb; 64 (01) 9-29
    Search in Google Scholar
  • Zambo I, Vesely K. [WHO classification of tumours of soft tissue and bone 2013: the main changes compared to the 3rd edition] . Cesk Patol 2014; Apr; 50 (02) 64-70
    Search in Google Scholar
  • Rizzo V, Parissis H. Atypical presentation of soft tissue sarcoma. Ulster Med J 2017; Sep; 86 (03) 204-205
    Search in Google Scholar
  • Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM . Ann Surg Oncol 2010; Jun; 17 (06) 1471-1474
    Search in Google Scholar
  • Keung EZ, Chiang YJ, Voss RK, Cormier JN, Torres KE, Hunt KK. et al Defining the incidence and clinical significance of lymph node metastasis in soft tissue sarcoma. Eur J Surg Oncol 2018; Jan; 44 (01) 170-177
    Search in Google Scholar
  • MacNeill AJ, Gupta A, Swallow CJ. Randomized controlled trials in soft tissue sarcoma: we are getting there!. Surg Oncol Clin N Am 2017; Oct; 26 (04) 531-544
    Search in Google Scholar
  • Feig BW. Retroperitoneal sarcomas. Surg Oncol Clin N Am 2003; 12 (02) 369-377
    Search in Google Scholar
  • Kawaguchi N, Ahmed AR, Matsumoto S, Manabe J, Matsushita Y. The concept of curative margin in surgery for bone and soft tissue sarcoma. Clin Orthop Relat Res 2004; Feb; (419) 165-172
    Search in Google Scholar
  • Tinkle CL, Weinberg V, Braunstein SE, Wustrack R, Horvai A, Jahan T. et al Intraoperative radiotherapy in the management of locally recurrent extremity soft tissue sarcoma. Sarcoma 2015; 2015: 913565
    Search in Google Scholar
  • Pisters PW, Ballo MT, Fenstermacher MJ, Feig BW, Hunt KK, Raymond KA. et al Phase I trial of preoperative concurrent doxorubicin and radiation therapy, surgical resection, and intraoperative electron-beam radiation therapy for patients with localized retroperitoneal sarcoma. J Clin Oncol 2003; Aug; 21 (16) 3092-3097
    Search in Google Scholar
  • Yang JC, Chang AE, Baker AR, Sindelar WF, Danforth DN, Topalian SL. et al Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol 1998; Jan; 16 (01) 197-203
    Search in Google Scholar
  • Murakami T, DeLong J, Eilber FC, Zhao M, Zhang Y, Zhang N. et al Tumor- targeting Salmonella typhimurium A1-R in combination with doxorubicin eradicate soft tissue sarcoma in a patient-derived orthotopic xenograft (PDOX) model. Oncotarget 2016; Mar; 7 (11) 12783-90
    Search in Google Scholar
  • Blay JY, Brahmi M, Ray-Coquard I. European Journal of Cancer's Biennial report on soft tissue and visceral sarcomas or the rapid evolution of treatment concepts in sarcomas. Eur J Cancer 2017; Jan; 70: 83-86
    Search in Google Scholar
  • Westbury G. Amputations for soft tissue sarcoma. Ann R Coll Surg Engl 1991; May; 73 (03) 163-164
    Search in Google Scholar
  • Ikoma N, Roland CL, Torres KE, Chiang YJ, Wang WL, Somaiah N. et al Concomitant organ resection does not improve outcomes in primary retroperitoneal well- differentiated liposarcoma: a retrospective cohort study at a major sarcoma center. J Surg Oncol 2018; May; 117 (06) 1188-1194
    Search in Google Scholar