Autologous Fat Grafting after Sarcoma surgery: evaluation of oncological safety

Publication date: Available online 8 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Angela Pennati, Egidio Riggio, Giuseppe Marano, Elia Biganzoli

Abstract

Background

The regenerative effectiveness of lipoaspirate procedures relies on the presence of mesenchymal stem cells, but the stromal microenvironment and hormonal secretions of adipose tissue can be involved in cancer growth. Only few oncological outcome studies of fat grafting at the surgical site of malignant neoplasms of mesenchymal origin are available; none of these examined a series of sarcoma cases.

Objectives

We analyzed outcome in terms of local or distant spread and overall survival in order to investigate the oncological safety of fat grafting in sarcoma patients.

Patients and methods

Sixty consecutive patients who had undergone 143 fat grafting procedures after surgical resection of bone and soft tissue sarcomas of the head, trunk and limbs with clear resection margins were enrolled from 2004 to 2015 in our tertiary care center. A multidisciplinary sarcoma team administered adjuvant therapies. Patients were recurrence free at fat grafting.

Results

The overall median follow-up was 7.5 years. At follow-up after fat grafting (2.4 years), one patient had distant metastasis and two had local relapse. Kaplan-Meier analysis showed disease-free survival of 95.4% (CI:89.1-100.0) at 24 months. The risk of local recurrence within 24 months was 4.6% (CI:0.0-20.9). The probability of not having local recurrence after fat grafting was ≥89.1%.

Conclusion

We found no evidence of an increased cancer risk after fat grafting procedures in sarcoma patients, but a stimulatory role of fat cannot be excluded for bone sarcomas based on the cases reported here and further studies are therefore needed.