(P 361) WOUND COMPLICATIONS AFTER SOFT TISSUE SARCOMA RESECTION: A SINGLE-CENTER RETROSPECTIVE ANALYSIS

Objective: The treatment of high-grade soft tissue sarcoma typically involves neoadjuvant radiotherapy followed by surgical resection. Preoperative radiotherapy offers several potential advantages in treating soft tissue sarcomas (STS), enabling closer margins and function-preserving approach. However, it can adversely affect skin vascularisation, leading to a higher incidence of postoperative wound complications such as wound infection, dehiscence, skin necrosis, and seroma. These complications can increase patient morbidity and may require additional surgeries.
Primary objectives were to examine the incidence of postoperative complications (skin necrosis, wound dehiscence, infection, seroma, and hematoma) in patients who underwent sarcoma resection in MUMC+ in the past ten years. Secondary objectives looked at the effect of radiotherapy and plastic surgery on wound complications and which complications are the most prevalent within these groups.

Methods: We retrospectively analysed 260 patients who underwent soft tissue sarcoma resection at MUMC+ from 2014 to 2023. GISTs, fully retroperitoneal or intrapelvic tumors were excluded. Continuous variables were presented as means and standard deviations (SD), and categorical variables as frequencies and percentages. Complications were reported as incidence rates. Comparative analyses were conducted using the Chi-square test for independence. Binary logistic regression was used to identify independent predictors of postoperative complications, with results reported as odds ratios (OR) with 95% confidence intervals (CIs). Differences were considered significant at p < 0.05. All analyses were performed using SPSS© software (version 27).

Results: Wound complications were observed in 43% of patients following sarcoma resection. The most common included infection (23%), wound dehiscence (17%), seroma formation (13%), and skin necrosis (10%). Nearly half of the patients (48%) underwent neoadjuvant radiotherapy. This treatment was strongly associated with an increased overall incidence of wound complications (OR: 3.49, 95% CI: 1.93 – 6.29, p < 0.001), particularly infection (OR: 2.78, p = 0.004). Within the preoperative radiotherapy group, plastic surgery reconstruction showed a significant positive correlation with wound complications (OR: 2.15, 95% CI: 1.03 – 4.51, p = 0.042), with dehiscence being the most prevalent (OR: 5.12, p = 0.002).

Conclusion: This study demonstrates a significant association between preoperative radiotherapy and an increased risk of postoperative complications, particularly infection and skin necrosis. Patients undergoing plastic surgery reconstruction also exhibited higher complication rates, notably wound dehiscence, likely due to the extensive nature of their surgeries. Future research should focus on larger, prospective studies to validate these findings and explore the potential of advanced imaging techniques, such as ICGA, to improve surgical outcomes and reduce postoperative complications in sarcoma patients.