S. Kavalukas1, R. Baucom2, L. Huang1, S. Phillips1, C. Bailey1, R. Pierce1, M. Holzman1, K. Sharp1, B. Poulose1 1Vanderbilt University Medical Center,Department Of Surgery,Nashville, TN, USA 2Baylor University Medical Center,Dallas, TX, USA
Introduction: The effect of adjuvant therapy on subsequent ventral incisional hernia (VIH) formation after cancer resection is unknown. This study assessed the impact of adjuvant therapy on long term VIH formation after tumor resection for abdominal malignancy.
Methods: Patients undergoing resection of abdominal malignancy were retrospectively identified and followed up to 2 years by computed tomography (CT) scan for VIH formation. Those who received either chemotherapy and/or radiation 6 months before or after resection (adjuvant therapy, AT) were compared to patients without adjuvant therapy (no adjuvant therapy, NAT). Cox proportional hazards (CPH) regression was used identify factors associated with VIH formation over time while adjusting for multiple confounding factors.
Results: 485 patients underwent abdominal cancer resections (AT n=105; NAT n=380). The median age was 58 yrs for the AT group and 61 for the NAT group. 40% of the AT group and 41% of the NAT group were female. The clinical cancer stage breakdown was statistically significant between the 2 groups (AT had more stage 4 and NAT had more stage 1 cancers). The proportion of patients free of VIH at 24 months was 46% in the AT group and 39% in the NAT group (Figure, p=0.62). AT was not found to be associated with increased VIH compared to NAT in the CPH model (HR=0.817, 95% CI: (0.567, 1,177).
Conclusion: The rate of incisional hernia formation after resection for abdominal malignancy does not appear to be influenced by adjuvant chemo- or radiotherapy. Continued evaluation of risk factors and the role of hernia prevention is important to maintain quality of life for cancer survivors.
