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Predictors of local recurrence in high-grade soft tissue sarcomas: hydrogen peroxide as a local adjuvant. Orthopedics 2013 Feb;36(2):e207-15

Date

02/06/2013

Pubmed ID

23380016

DOI

10.3928/01477447-20130122-24

Scopus ID

2-s2.0-84874074792 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

Soft tissue sarcomas have a mortality rate of 40% to 60%, with local recurrence being a poor prognostic factor for overall survival. Three-percent nondiluted hydrogen peroxide is hypothesized to be an effective local adjuvant. The purpose of this study was to identify risk factors for local recurrence in high-grade soft tissue sarcomas and to determine whether using hydrogen peroxide as a local adjuvant reduced the risks of local recurrence and surgical-site infection. Retrospective data were collected for 106 patients surgically treated for high-grade soft tissue sarcomas between 2002 and 2010. The primary endpoint was local recurrence. Eighteen (16.98%) cases of local recurrence occurred. Predictors of local recurrence were margin status, estimated blood loss, and histology (ie, malignant peripheral nerve sheath tumor), with hazard ratios of 4.44 (95% confidence interval [CI], 1.32-14.95), 1.19 (95% CI, 1.06-1.35), and 9.21 (95% CI, 2.11-40.16), respectively. Hydrogen peroxide yielded a statistically insignificant improvement in local recurrence, with a hazard ratio of 0.81 (95% CI, 0.27-2.48) and a reduced risk of surgical site infection, with a hazard ratio of 0.52 (95% CI, 0.15-1.81). Margin status, increased blood loss, and histologic subtype are associated with increased local recurrence risk. Using hydrogen peroxide improved local control and infection rates, but the difference was not statistically significant.

Author List

Wooldridge AN, Kolovich GP, Crist MK, Mayerson JL, Scharschmidt TJ

Author

Adam Neal Wooldridge MD, MPH Assistant Professor in the Orthopaedic Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Administration, Topical
Adult
Aged
Antineoplastic Agents
Female
Humans
Hydrogen Peroxide
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Recurrence, Local
Retrospective Studies
Risk Factors
Sarcoma
Soft Tissue Neoplasms
Surgical Wound Infection