Predictors of Local Recurrence in High-grade Soft Tissue Sarcomas: Hydrogen Peroxide as a Local Adjuvant

摘要

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 [Cl], 1.32-14.95), 1.19 (95% Cl, 1.06-1.35), and 9.21 (95% Cl, 2.11 -40.16), respectively. Hydrogen peroxide yielded a statistically insignificant improvement in local recurrence, with a hazard ratio of 0.81 (95% Cl, 0.27-2.48) and a reduced risk of surgical site infection, with a hazard ratio of 0.52 (95% Cl, 0.15-1.81).