oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2022-21-1-91-98oncotomsk-2031Research ArticleОПЫТ РАБОТЫ ОНКОЛОГИЧЕСКИХ УЧРЕЖДЕНИЙONCOLOGY PRACTICEВлияние ожирения на онкологические и хирургические результаты лечения саркомы мягких тканей бедраImpact of obesity on the oncological and surgical outcomes of thigh soft tissue sarcomahttps://orcid.org/0000-0002-2924-4207ХамдиО.HamdyO.

Омар Хамди, MD, преподаватель, отделение хирургической онкологии

Researcher ID (WOS): W-8287-2019. Author ID (Scopus): 57200278486

Мансура

Omar Hamdy, MD, Lecturer

Researcher ID (WOS): W-8287-2019. Author ID (Scopus): 57200278486

Mansoura

omarhamdy87@gmail.comhttps://orcid.org/0000-0001-6503-4867АталлаХ.AtallahKh.

Халид Аталла, MSc, преподаватель

Author ID (Scopus): 57208687994

Мансура

Khalid Atallah, MSc, Assistant Lecturer

Author ID (Scopus): 57208687994

Mansoura

https://orcid.org/0000-0002-7150-9424РосМ. Х.RosM. H.

Мохамед Х. Рос, MB BCh, медицинский стажер

Author ID (Scopus): 57208507986

Мансура

Mohamed H. Ros, MB BCh, Medical Intern

Author ID (Scopus): 57208507986

Mansoura

https://orcid.org/0000-0002-5981-9614МетваллиИ. Х.MetwallyI. H.

Ислам Х. Метвалли, MD, MRCS, член Королевской коллегии хирургов

Author ID (Scopus): 57142135100

Мансура

Islam H. Metwally, MD, MRCS, Lecturer

Author ID (Scopus): 57142135100

Mansoura

Отделение хирургической онкологии, онкологический центр Университета МансурыЕгипетSurgical Oncology Unit, Oncology Center Mansoura University (OCMU)EgyptУниверситетские больницы МансурыЕгипетMansoura University HospitalsEgypt2022030320222119198Copyright © Хамди О., Аталла Х., Рос М.Х., Метвалли И.Х., 20222022Хамди О., Аталла Х., Рос М.Х., Метвалли И.Х.Hamdy O., Atallah K., Ros M.H., Metwally I.H.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/2031Актуальность

Актуальность. Злокачественные опухоли мягких тканей являются гетерогенной группой опухолей с разичным прогнозом и тенденцией к частому рецидивированию и отдаленному метастазированию, преимущественно в легкие. Ожирение представляет собой глобальную проблему, являясь известным фактором риска многих заболеваний, в том числе злокачественных новооборазований. Хотя бедро представляет собой одну из основных областей отложения жира, оно является одним из наиболее частых зон возникновения саркомы мягких тканей. Мы проанализировали влияние ожирения на исходы лечения у пациентов с саркомой мягких тканей (СМТ) бедра.

Материал и методы

Материал и методы. Представлен ретроспективный анализ результатов лечения больных с саркомами конечностей за период с января 2008 г. по январь 2020 г. Изучены эпидемиологические и клинические данные, а также хирургические и онкологические результаты лечения больных СМТ бедра с ожирением (ИМТ более 30) и без него. Мы предположили, что отложение жира в области бедра у пациентов с ожирением может затруднить диагностику СМТ и привести к выявлению опухолей большего размера и стадии, что может повлиять на безрецидивную выживаемость и общую выживаемость.

Результаты

Результаты. Пациенты с ожирением имели опухоли значимо большего размера (медиана – 14,7 против 9,9 см) и более высокую стадию Т. Cредний диаметр новообразований при липосаркомах составлял 15,1 см, при опухолях иного гистотипа – 11,3 см (p=0,023). Чаще всего наблюдались отдаленные метастазы в легких, однако их частота в сравниваемых группах значимо не различалась. Послеоперационные осложнения чаще возникали у пациентов с ожирением (p=0,025). Общая и безрецидивная выживаемость (БРВ) не отличались между группами, хотя пациенты с ожирением, как правило, имеют меньшую БРВ.

Заключение

Заключение. Ожирение усложняло диагностику и лечение сарком конечностей, но, по-видимому, оно не оказывало влияиния на показатели выживаемости.

Background

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

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

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 nonobese 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

Conclusion. Obesity added complexity to the diagnosis and treatment of extremity sarcoma, but seems not to affect survival.

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The authors declare that there are no conflicts of interest present.