Carolina Curioni, Tim Pruimboom, Robert JCMF de Kleijn, Christel Meers-Haekens, Frederik WK Wesseling, Kristien Keymeulen, Marc HA Bemelmans, Shan Shan Qiu and Sanne M. E. Engelen*
Background: The treatment of high-grade soft tissue sarcoma of the extremities and abdominal/trunk wall requires neoadjuvant radiotherapy followed by surgical resection. Neoadjuvant Radiotherapy (RTx) may result in closer resection margins and a more function-preserving approach. However, radiotherapy has a detrimental effect on tissue vascularization, leading to a higher incidence of Postoperative Wound Complications (PWC). Wound complications can increase morbidity, decrease quality of life and may require additional interventions. In this study we examine the postoperative wound complication rate in patients who underwent sarcoma resection in Maastricht University Medical Center (MUMC+) in the past ten years. Moreover, we aim to determine the effect of neoadjuvant radiotherapy and Plastic Surgical Reconstruction (PSR) on wound complications. Methods: 260 patients who underwent soft tissue sarcoma resection at our center between 2014 and 2023 were retrospectively analyzed. The total wound complication rate was recorded per complication, and the patient cohort was subdivided into groups of patients who received neoadjuvant radiotherapy or not and/or plastic surgical reconstruction or not. Wound complications were scored as no wound complications, Minor Wound Complication (MiWC) and major wound complication (MaWC). Results: Postoperative wound complications were recorded in 44.6% of patients, including infection (23%), wound dehiscence (17%), seroma (13%), and skin necrosis (8%). Neoadjuvant radiotherapy and plastic surgical reconstruction were both associated with an increased overall wound complication incidence (OR: 3.75, 95% CI: 2.08–6.74, p<0.001 and OR: 1.85, 95% CI: 1.05–3.28, p=0.034, respectively). In the radiotherapy group, infection was the most prevalent complication (OR: 2.78, p=0.004). The patients in the plastic surgical reconstruction group experienced predominantly minor wound complications. Dehiscence was the most prevalent complication in this group of patients (OR: 3.48, p=0.002). Conclusion: This study showed that neoadjuvant radiotherapy and plastic surgical reconstruction for sarcoma patients are both associated with an increase in wound complication rate. Plastic surgical reconstruction was predominantly associated to minor complications. Future studies should focus on lowering the wound complication rates and improving care for sarcoma patients.
Freddy Houehanou Rodrigue GNANGNON*, Marthe Alice AGOSSOU, Yacoubou IMOROU SOUAIBOU, Moufalilou ABOUBAKAR, Patrice DANGBEMEY, Josiane Angéline Adjoua TONATO-BAGNAN, Dansou Gaspard GBESSI, DENAKPO Justin Lewis and Francis Moise DOSSOU
Introduction: Breast cancer is a major public health problem. Its management is particularly difficult in countries with limited resources. Surgery is sometimes the only therapeutic option available. Our objective was to study the place of surgery in this management in the Republic of Benin. Methods: This was a descriptive and analytical multicenter study that included medical records of patients undergoing surgery for breast cancer over the period from January 2013 to October 2019 in two university hospitals in Cotonou, southern Republic of Benin. Results: The 141 included patients had an average age of 47.2 years. Surgery was of curative intent in 84.4% of cases. Mastectomy was the most common treatment (92.9%). The Patey technique modified by Madden (81.56%) was the most used technique. The overall morbidity was 8.5% dominated by postoperative hematoma. The other therapeutic methods used were chemotherapy (95.7%) and radiotherapy (37.8%). Conclusion: Breast cancer surgery is dominated in our context by mastectomy. The development of conservative surgery and oncoplasty, associated with a policy of organized screening program and better access to radiotherapy, will improve the supply of care.
Freddy Houéhanou Rodrigue GNANGNON*, Hénok Mahutin DÉPKÉMADOHA, Ganiou ADJADÉ, Patrice DANGBEMEY, Gilbert FASSINOU, Fidèle AGOSSOU, Moufalilou ABOUBAKAR and Dansou Gaspard GBESSI
Background: Breast cancer is a major global health concern, particularly in low-resource settings like Benin, where late-stage presentation often necessitates mastectomy. Mastectomy, while therapeutic, profoundly impacts body image, sexuality and psychosocial well-being. However, evidence on these post-mastectomy outcomes is scarce in the Beninese context. This study aimed to assess the Quality of Life (QoL), psychosocial experience and symptoms of anxiety and depression among mastectomized women in southern Benin. Methods: We conducted a descriptive and analytical cross-sectional study from August to December 2023 in two tertiary hospitals in Cotonou. Fifty consecutive women who had undergone total or partial mastectomy at least two months prior were recruited. Data were collected using a structured questionnaire that included sociodemographic and clinical variables, the EORTC QLQ-C30 (global QoL), the EORTC QLQ-BR23 (breast cancer–specific domains) and the Hospital Anxiety and Depression Scale (HADS) for psychosocial assessment. Statistical significance was set at p<0.05. Results: The 50 participants had a mean age of 55.4 years. Most had received chemotherapy (98%) and radiotherapy (79%). The mean global quality-of-life score (EORTC QLQ-C30) was 69.4, with generally high physical, emotional, cognitive and social functioning scores. Sexual functioning and sexual satisfaction were the most impaired domains, while body image scores remained moderate. Only 2.3% of women presented clinically significant depressive symptoms on the HADS. Age, education level, income and family support showed significant associations with several quality-of-life dimensions (p<0.05). Conclusion: Despite socioeconomic constraints, mastectomized women in southern Benin reported overall satisfactory quality of life, although sexual functioning remained notably affected. These results underscore the critical need for integrated psychosocial and sexual support in survivorship care and provide initial evidence to inform patient-centred breast cancer care in Benin.
Archives of Surgical Oncology received 37 citations as per Google Scholar report
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