Surgical Treatment for Primary Chest Wall Sarcoma: A Single-Institution Study

J Surg Res. 2021 Apr:260:149-154. doi: 10.1016/j.jss.2020.11.078. Epub 2020 Dec 16.

Abstract

Background: Primary sarcomas of the chest wall are rare aggressive tumors. Surgery is part of the multimodal treatment. We describe our institutional patient cohort and evaluate prognostic factors.

Methods: All patients who had curative intent surgery for primary chest wall sarcoma from 2004 to 2019 were retrospectively reviewed. Impact on survival-calculated from the date of surgery until last follow-up- was assessed for the following variables: age, gender, type of resection, size, grading, stage, completeness of resection, and neoadjuvant and adjuvant therapy.

Results: Twenty-three patients (15 males, 65%) with a median age of 54 y (4 to 82) were included. Most common histology was chondrosarcoma (n = 5, 22%). Seven patients (30%) received neoadjuvant and 13 patients (57%) received adjuvant treatment. R0 resection was achieved in 83%. Extended chest wall resection was performed in 14 patients (61%), including lung (n = 13, 57%), diaphragm (n = 2, 9%) and pericardium (n = 1, 4%). Morbidity and 90-day mortality were 23% and 0%, respectively. Three- and 5-year overall survival was 53% and 35%, respectively. R0 resection was predictor of overall survival (P = 0.029). Tumor grade and extended resections were predictors for recurrence (P = 0.034 and P = 0.018, respectively).

Conclusions: Surgical resection of primary chest wall sarcoma is a safe procedure even when extended resection is required.

Keywords: Chest wall reconstruction; Chest wall sarcoma; Extended resection; Multimodality treatment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Sarcoma / diagnosis
  • Sarcoma / mortality
  • Sarcoma / surgery*
  • Survival Analysis
  • Thoracic Neoplasms / diagnosis
  • Thoracic Neoplasms / mortality
  • Thoracic Neoplasms / surgery*
  • Thoracic Wall / surgery*
  • Treatment Outcome
  • Young Adult