Obesity is associated with larger soft‐tissue sarcomas, more surgical complications, and more complex wound closures (obesity leads to larger soft‐tissue sarcomas)

Background and Objectives Does a link exist between obesity and soft‐tissue sarcoma outcomes? We hypothesized that soft‐tissue sarcomas in patients with obesity may lead to larger tumors at detection, with an increased risk for a more complex surgical excision, wound healing‐related complications, higher stage at presentation, and decreased survival. Methods One hundred thirty‐nine and patients with soft‐tissue sarcoma were retrospectively evaluated over 10 years. Patients were divided into 2 cohorts based on the World Health Organization body mass index (BMI) obesity grouping. A BMI ≥ 30 kg/m 2 was classified as obese and a BMI < 30 kg/m 2 was classified as nonobese. Results Eighty‐five nonobese and 54 obese individuals were evaluated. The median tumor diameter was 50% larger ( P  = .024) and the overall complication rate was 1.7‐fold higher in patients with obesity ( P  = .0032). Patients with obesity also had a statistically significantly higher rate of complex wound closures. In multivariable logistic regression, obesity remained a highly significant factor favoring complications after the surgical treatment of soft‐tissue sarcoma (odds ratio = 3.66, 95% confidence interval = 1.54‐8.71; P  = .0033). No statistically significant differences were noted on comparing groups for the incidence of metastatic spread or survival. Conclusions These findings suggest that obesity is associated with larger tumors, a higher incidence of wound complications, and greater use of complex wound‐closure methods.