Impact of obesity on the oncological and surgical outcomes of thigh soft tissue sarcoma
Автор: Hamdy O., Atallah Kh., Ros M.H., Metwally I.H.
Журнал: Сибирский онкологический журнал @siboncoj
Рубрика: Опыт работы онкологических учреждений
Статья в выпуске: 1 т.21, 2022 года.
Бесплатный доступ
Background. malignant soft tissue tumors are a heterogeneous group with variable prognosis and with a tendency to recurrence and distant spread, mainly to the lungs. also, obesity is a known risk factor for many diseases and cancers and is currently a global problem. While the thigh is one of the main fat deposition areas, it is one of the commonest sites for the incidence of soft tissue sarcoma. We tried to illustrate the impact of obesity on the outcomes of thigh soft tissue sarcoma patients. material and methods. We retrospectively recruited data of extremity sarcomas treated at our hospital from January 2008 to January 2020. the epidemiological and clinical data of all the included patients was analyzed, then the surgical and oncological outcomes between obese and non-obese patients were compared (defining obesity as Bmi more than 30). We hypothesized that fat deposition in the thigh in obese patients may delay the diagnosis of soft tissue sarcoma, lead to the discovery of the masses at a larger size and stage, and hence may affect the disease-free survival and the overall survival. Results. obese patients had significantly larger size tumors (median: 14.7 vs 9.9 cm) and as such significantly higher t stage. another significant finding was that the mean diameter of liposarcoma tumours was 15.1 cm, while that of non-liposarcomas was 11.3 cm (p-value=0.023). also, although they did not have a higher prevalence of distant metastasis at initial diagnosis, their metastasis tends to be isolated in the lung. postoperative complications occurred more frequently in obese patients in comparison to non-obese patients (p-value=0.025). Neither overall nor disease-free survivals were different among both groups, although obese patients tend to have shorter dFs. conclusion. obesity added complexity to the diagnosis and treatment of extremity sarcoma, but seems not to affect survival.
Soft tissue tumours, extremity tumours, obesity, survival
Короткий адрес: https://sciup.org/140290561
IDR: 140290561 | DOI: 10.21294/1814-4861-2022-21-1-91-98
Список литературы Impact of obesity on the oncological and surgical outcomes of thigh soft tissue sarcoma
- Hasley I., Gao Y., Blevins A.E., Miller B.J. The Significance of a «Close» Margin in Extremity Sarcoma: A Systematic Review. Iowa Orthop J. 2018; 38: 123-30.
- Jacobs A.J., Michels R., Stein J., Levin A.S. Improvement in Overall Survival from Extremity Soft Tissue Sarcoma over Twenty Years. Sarcoma. 2015; 2015: 279601. https://doi.org/10.1155/2015/279601.
- Atean I., Pointreau Y., Rosset P., Garaud P., De-Pinieux G., Calais G. Prognostic factors of extremity soft tissue sarcoma in adults. A single institutional analysis. Cancer/Radiothérapie. 2012; 16(8): 661-6.
- Park J.H., Kang C.H., Kim C.H., Chae I.J., Park J.H. Highly malignant soft tissue sarcoma of the extremity with a delayed diagnosis. World J Surg Oncol. 2010; 8: 84. https://doi.org/10.1186/1477-7819-8-84.
- Alamanda V.K., Moore D.C., Song Y., Schwartz H.S., Holt G.E. Obesity does not affect survival outcomes in extremity soft tissue sarcoma. Clin Orthop Relat Res. 2014; 472(9): 2799-806. https://doi.org/10.1007/s11999-014-3714-7.
- Karastergiou K., Smith S.R., Greenberg A.S., Fried S.K. Sex differences in human adipose tissues - the biology of pear shape. Biol Sex Differ. 2012; 3(1): 13. https://doi.org/10.1186/2042-6410-3-13.
- Gamboa A.C., Gronchi A., Cardona K. Soft-tissue sarcoma in adults: An update on the current state of histiotype-specific management in an era of personalized medicine. CA Cancer J Clin. 2020; 70(3): 200-29. https://doi.org/10.3322/caac.21605.
- Casali P.G., Abecassis N., Aro H.T., Bauer S., Biagini R., Bielack S., Bonvalot S., Boukovinas I., Bovee J.V.M.G., Brodowicz T., Broto J.M., Buonadonna A., De Álava E., Dei Tos A.P., Del Muro X.G., Dileo P., Eriksson M., Fedenko A., Ferraresi V., Ferrari A., Ferrari S., Frezza A.M., Gasperoni S., Gelderblom H., Gil T., Grignani G., Gronchi A., Haas R.L., Hassan B., Hohenberger P., Issels R., Joensuu H., Jones R.L., Judson I., Jutte P., Kaal S., Kasper B., Kopeckova K., Krákorová D.A., Le Cesne A., Lugowska I., Merimsky O., Montemurro M., Pantaleo M.A., Piana R., Picci P., Piperno-Neumann S., Pousa A.L., Reichardt P., Robinson M.H., Rutkowski P., Safwat A.A., Schöffski P., Sleijfer S., Stacchiotti S., Sundby Hall K., Unk M., Van Coevorden F., van der Graaf W.T.A., Whelan J., Wardelmann E., Zaikova O., Blay J.Y.; ESMO Guidelines Committee and EURACAN. Soft tissue and visceral sarcomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018; 29. https://doi.org/10.1093/annonc/mdy096.
- Puri A., Gulia A. Management of extremity soft tissue sarcomas. Indian J Orthop. 2011; 45(4): 301-6. https://doi.org/10.4103/0019-5413.82332.
- Brinkmann E.J., Ahmed S.K., Houdek M.T. Extremity Soft Tissue Sarcoma: Role of Local Control. Curr Treat Options Oncol. 2020; 21(2): 13. https://doi.org/10.1007/s11864-020-0703-9.
- Montgomery C., Harris J., Siegel E., Suva L., Wilson M., Morell S., Nicholas R. Obesity is associated with larger soft-tissue sarcomas, more surgical complications, and more complex wound closures (obesity leads to larger soft-tissue sarcomas). J Surg Oncol. 2018; 118(1): 184-91. https://doi.org/10.1002/jso.25119.
- Stevenson M.G., Musters A.H., Geertzen J.H.B., van Leeuwen B.L., Hoekstra H.J., Been L.B. Amputations for extremity soft tissue sarcoma in an era of limb salvage treatment: Local control and survival. J Surg Oncol. 2018; 117(3): 434-42. https://doi.org/10.1002/jso.24881.
- Byerly S., Chopra S., Nassif N.A., Chen P., Sener S.F., Eisenberg B.L., Tseng W.W. The role of margins in extremity soft tissue sarcoma. J Surg Oncol. 2016; 113(3): 333-8. https://doi.org/10.1002/jso.24112.
- Al-Refaie W.B., Habermann E.B., Jensen E.H., Tuttle T.M., Pisters P.W., Virnig B.A. Surgery alone is adequate treatment for early stage soft tissue sarcoma of the extremity. Br J Surg. 2010; 97(5): 707-13. https://doi.org/10.1002/bjs.6946.
- Endo M., Lin P.P. Surgical margins in the management of extremity soft tissue sarcoma. Chin Clin Oncol. 2018; 7(4): 37. https://doi.org/10.21037/cco.2018.08.10.
- Umer H.M., Umer M., Qadir I., Abbasi N., Masood N. Impact of unplanned excision on prognosis of patients with extremity soft tissue sarcoma. Sarcoma. 2013. https://doi.org/10.1155/2013/498604.
- Hales C.M., Carroll M.D., Fryar C.D., Ogden C.L. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. 2020; (360): 1-8.
- Wang Y., Beydoun M.A., Min J., Xue H., Kaminsky L.A., Cheskin L.J. Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic. Int J Epidemiol. 2020; 49 (3): 810-23. https://doi.org/10.1093/ije/dyz273.
- Wolin K.Y., Carson K., Colditz G.A. Obesity and cancer. Oncologist. 2010; 15(6): 556-65. https://doi.org/10.1634/theoncologist.2009-0285.
- Nguyen D.M., El-Serag H.B. The epidemiology of obesity. Gastroenterol Clin North Am. 2010; 39(1): 1-7. https://doi.org/10.1016/j.gtc.2009.12.014.
- Hruby A., Hu F.B. The Epidemiology of Obesity: A Big Picture. Pharmacoeconomics. 2015; 33(7): 673-89. https://doi.org/10.1007/s40273-014-0243-x.
- Alebshehy R., Shuaib N.M., Mbako J.D., Barffo D., Nuotol R.K. Determinant Analysis of Obesity among Adult Females in Egypt. Egypt J Hosp Med. 2016; 65(1): 662-9. https://doi.org/10.12816/0033779.
- Tavani A., Soler M., La Vecchia C., Negri E., Gallus S., Franceschi S. Body weight and risk of soft-tissue sarcoma. Br J Cancer. 1999; 81(5): 890-2. https://doi.org/10.1038/sj.bjc.6690781.
- Houdek M.T., Hevesi M., Griffin A.M., Wunder J.S., Ferguson P.C. Morbid Obesity Is Associated With an Increased Risk of Wound Complications and Infection After Lower Extremity Soft-tissue Sarcoma Resection. J Am Acad Orthop Surg. 2019; 27(21): 807-15. https://doi.org/10.5435/JAAOS-D-18-00536.