Chest Wall Sarcoma: Outcome in 22 Patients After Resection Requiring Thoracic Cage Reconstruction
| Autor: | Göran Hambraeus, Anders Rydholm, Per Jönsson, Ramon Lillo-Gil, Erik Gyllstedt |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
medicine.medical_specialty
Rib cage business.industry medicine.medical_treatment Soft tissue lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease lcsh:RC254-282 Prosthesis Surgery medicine.anatomical_structure Oncology Orthopedic surgery medicine Pericardium Radiology Nuclear Medicine and imaging Marlex Sarcoma Chondrosarcoma business Research Article |
| Zdroj: | Sarcoma, Vol 2, Iss 3-4, Pp 143-147 (1998) Sarcoma |
| ISSN: | 1369-1643 1357-714X |
| Popis: | Purpose. To evaluate the outcome after resection of malignant chest wall sarcoma, requiring reconstruction of the chest wall. Subjects. Twenty-two patients, 15 with primary tumours, were operated on in our institution between 1983 and 1996. Four patients underwent surgery after a previous intralesional or marginal excision and three patients because of a local recurrence. Methods. The tumour was resected ‘en bloc’, including skin, muscle and thoracic skeleton. When necessary, adjacent organs invaded by the tumour, such as lung, pericardium and diaphragm, were also removed to obtain a wide margin. Reconstruction of the chest wall was performed with Marlex mesh (n=9), methylmethacrylate cement (n=2) or a Marlex methylmethacrylate ‘sandwich’ (n=11). Results. The median tumour size was 9.5 (2–20) cm. The most common type of tumour was chondrosarcoma (12 cases). No patient died in hospital. Five patients required reoperation because of complications, two patients because of loosening of the acrylate prosthesis, two because of necrosis of soft tissue coverage and one was reoperated because of bleeding. Four patients died of generalized tumour disease between 5 and 77 months after surgery and one patient died of a local recurrence 32 months after the primary operation. Seventeen patients are alive, with a median follow-up of 36 (4–162) months. Microscopic radicality (negative margin) was achieved in 17 patients but 5 of these had local recurrences. Two of five patients with positive margins had a local recurrence of the tumour. Of the seven patients with local recurrences, two also developed metastases. Discussion. Large chest wall sarcomas can be successfully resected and the chest wall reconstructed with low morbidity and mortality. |
| Databáze: | OpenAIRE |
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