Association between postoperative surgical site infection and oncologic outcomes in soft tissue sarcoma: a propensity score-matched analysis using the bone and soft tissue registry.

PURPOSE: Postoperative surgical site infection (SSI) is a prevalent complication. The impact of SSI on oncologic outcomes in soft tissue sarcoma (STS) remains debatable. This study evaluates the correlation between SSI and prognosis following STS resection through analysis of a national registry and propensity score matching (PSM).

METHODS

We conducted a retrospective cohort study using data from the Japanese Nationwide Bone and Soft Tissue Tumor (BSTT) Registry between 2006 and 2019. The study included patients aged 18 years or older with localized primary STS who underwent surgical resection. PSM at a 1:3 ratio was performed using 11 baseline variables to ensure balance in patient and tumour characteristics between the SSI and non-SSI groups. The overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were analyzed using the Kaplan-Meier method and compared using the log-rank test.

RESULTS

A total of 6,303 patients met the inclusion criteria, of whom 226 (3.6%) developed SSI. Prior to matching, the SSI group exhibited significantly poorer OS (5-year rate: 74.0% vs. 80.0%, p = 0.044) and DMFS (5-year rate: 63.1% vs. 72.4%, p = 0.02). Following PSM, 221 matched pairs (n = 884) were analyzed, and no significant differences in OS (p = 0.53) and DMFS (p = 0.19) were observed between the SSI and non-SSI groups.

CONCLUSIONS

Postoperative SSIs were not significantly associated with oncologic outcomes after adjusting for confounding factors. These findings suggest that SSI may not be an independent prognostic factor in patients with STS.