Early wound complications after soft tissue sarcoma surgery; Association with local recurrence and death

In sarcoma surgery, a relationship between local complications after tumor resection and the risk of recurrent disease has been suggested. We aimed to investigate the relationship between early wound complications and soft tissue sarcoma (STS) local tumor recurrence (LR) and overall patient survival (OS) in a single Swedish tertiary centre.

Patients 15 years or older, operated for first time STS in trunk or limbs in one centre during 2010-2022 were considered. Patient files and national- and local registries were used to collect information on comorbidities, adjuvant treatments, tumor characteristics, wound complications, recurrence and death. Only wound complications requiring medication or surgery were considered. An inverse probability weighted model was used to balance for differences between groups.

596 patients were included in the study. 186 (31%) developed wound complication within 30 days. 34 (18%) of patients with a complication had LR, compared to 58 (14%) of those without (p= 0.196). Inverse probability weighting and cox regression could not link early wound complications to recurrence. Only patients with no missing data were included in survival analyses, making 575 patients eligible. Local recurrence free survival (LRFS) was 10 months shorter on average (62 vs 72 months, SD=48, p = 0.018) in study participants who developed wound complications compared to those who did not. Regardless of underlying risk profile (malignancy grade, comorbidities and metastatic disease), wound complications remained an independent risk factor for death (HR 1.43 [1.05 1.96] p = 0.024).

Early wound complications after surgery for STS were associated with reduced LRFS and OS.