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Chest wall sarcoma: outcome in 22 patients after resection requiring thoracic cage reconstruction.

Jönsson, Peter LU ; Gyllstedt, Erik LU ; Hambraeus, G; Lillogil, R and Rydholm, Anders LU (1998) In Sarcoma 2(3-4). p.143-147
Abstract
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'... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Sarcoma
volume
2
issue
3-4
pages
143 - 147
publisher
Hindawi Publishing Corporation
external identifiers
  • PMID:18521246
  • Scopus:18744434879
ISSN
1357-714X
DOI
10.1080/13577149877894
language
English
LU publication?
yes
id
9c7196db-1fcd-4c7b-9918-5ea2d94458c5 (old id 1169234)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18521246?dopt=Abstract
date added to LUP
2008-07-03 09:30:17
date last changed
2016-10-13 04:26:46
@misc{9c7196db-1fcd-4c7b-9918-5ea2d94458c5,
  abstract     = {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.},
  author       = {Jönsson, Peter and Gyllstedt, Erik and Hambraeus, G and Lillogil, R and Rydholm, Anders},
  issn         = {1357-714X},
  language     = {eng},
  number       = {3-4},
  pages        = {143--147},
  publisher    = {ARRAY(0x902a310)},
  series       = {Sarcoma},
  title        = {Chest wall sarcoma: outcome in 22 patients after resection requiring thoracic cage reconstruction.},
  url          = {http://dx.doi.org/10.1080/13577149877894},
  volume       = {2},
  year         = {1998},
}