title: Patterns of major wound complications following multidisciplinary therapy for lower extremity soft tissue sarcoma.
abstract: OBJECTIVE
  The purpose of this study was to determine the pattern and timing of major wound complications (MWCs) in patients at our institution who received multimodality treatment for lower extremity soft tissue sarcoma (LE-STS) and to evaluate the impact of MWCs on tumor control and patient outcomes.
  
  
  METHODS
  The medical records of 102 LE-STS patients treated with limb-sparing surgery and radiation therapy were reviewed. MWCs were defined as secondary operations with anesthesia, seroma/hematoma aspiration, admission for IV antibiotics, or persistent deep packing.
  
  
  RESULTS
  MWCs occurred in 22% of patients, with 45% of events occurring >120 days after resection. On multivariate analysis, preoperative external beam radiation therapy (EBRT) (OR 4.29, 95% CI 1.06-17.40, P = 0.042) and skin graft placement (OR 6.39, 95% CI 1.37-29.84, P = 0.018) were found to be independent predictors of MWCs. MWC occurrence did not predict for chronic toxicity and did not impact tumor control or survival.
  
  
  CONCLUSIONS
  A considerable proportion of MWCs occur >120 days from surgical resection with preoperative EBRT and skin graft placement independent predictors for MWCs. While an additional source of morbidity, MWC occurrence did not impact tumor control, nor did it predict for chronic toxicity. J. Surg. Oncol. 2016;114:385-391. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Radiation Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Miller
authors.affiliation: Center for Biostatistics, The Ohio State University, Columbus, Ohio.
authors.forename: Xiaokui
authors.initials: X
authors.lastname: Mo
authors.affiliation: Department of Radiation Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: Nicole T
authors.initials: NT
authors.lastname: Andonian
authors.affiliation: Department of Radiation Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: Karl E
authors.initials: KE
authors.lastname: Haglund
authors.affiliation: Department of Radiation Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Martin
authors.affiliation: Department of Medical Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: David A
authors.initials: DA
authors.lastname: Liebner
authors.affiliation: Department of Medical Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: James L
authors.initials: JL
authors.lastname: Chen
authors.affiliation: Department of Pathology, The Ohio State University, Columbus, Ohio.
authors.forename: Obiajulu H
authors.initials: OH
authors.lastname: Iwenofu
authors.affiliation: Department of Radiation Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: Arnab
authors.initials: A
authors.lastname: Chakravarti
authors.affiliation: Department of Orthopaedic Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Scharschmidt
authors.affiliation: Department of Orthopaedic Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: Joel L
authors.initials: JL
authors.lastname: Mayerson
authors.affiliation: Department of Surgical Oncology and the Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.
authors.forename: Raphael E
authors.initials: RE
authors.lastname: Pollock
authors.affiliation: Department of Radiation Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: Meng
authors.initials: M
authors.lastname: Xu-Welliver
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D012509:Sarcoma / Q000401:mortality / Q000628:therapy*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: lower extremity; radiotherapy; sarcoma; wounds and injuries