Sarcoma and Cutaneous Tumors

PV QA 2 - Poster Viewing Q&A 2

MO_20_2557 - Is Malnutrition Associated with Postoperative Complications in Patients with Primary Bone Sarcomas?

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Is Malnutrition Associated with Postoperative Complications in Patients with Primary Bone Sarcomas?
A. PARK1, K. A. Raskin2, J. H. Schwab2, K. De Amorim Bernstein3, and S. Lozano Calderon1; 1MGH, BOSTON, MA, 2Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, 3Massachusetts General Hospital, Boston, MA

Purpose/Objective(s): The purpose of this study is to evaluate whether malnutrition is associated with a higher rate of postoperative complications in patients with primary bone sarcomas requiring surgical therapy.

Materials/Methods: We retrospectively identified 275 patients aged 18 and older who underwent surgery for primary bone sarcomas between 1992 and 2014 and who also had albumin values recorded within 4 weeks prior to surgery. Postoperative complications were defined as infection, hematoma, need for additional surgery, or wound complications. Demographic data were recorded as were comorbidities, laboratory values, treatment with chemotherapy and/or radiation, and tumor characteristics such as type, grade, and location.

Results: Of the 275 patients, there were 172 patients with osteosarcoma, 15 with Ewing’s sarcoma, 66 with chondrosarcoma, and 24 with other types of sarcomas. In the bivariate analysis, age, alcohol use, total lymphocyte count (TLC) < 1000, albumin < 2.7, neoadjuvant chemotherapy, neoadjuvant radiotherapy, and location in the pelvis were associated with postoperative complications (P < 0.05). In the multivariate analysis, age (P = 0.04), pelvic location (P = 0.04), and neoadjuvant radiotherapy (P = 0.008) were independently associated with postoperative complications. We then performed a sub-analysis of patients without a pelvic tumor who also did not receive radiotherapy (n = 178). In this population, albumin < 2.7 was found to be independently associated with postoperative complications (relative risk = 4.69, 95% confidence interval = [1.03-21.34], P = 0.04).

Conclusion: This study demonstrates that hypoalbuminemia (albumin < 2.7) is associated with postoperative complications in patients with extremity bone sarcomas who do not receive radiation. Future studies are necessary to further elucidate the role of nutrition, and they may show that nutritional status is a modifiable risk factor that can be optimized to improve the outcome of surgery for primary bone sarcomas.

Author Disclosure: A. PARK: None. K.A. Raskin: None. K. De Amorim Bernstein: None. S. Lozano Calderon: None.

Karen De Amorim Bernstein, MD

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