Surgical treatment of primary soft tissue sarcomas involving the chest: experiences in 25 patients

Thorac Cardiovasc Surg. 2006 Apr;54(3):182-7. doi: 10.1055/s-2005-872973.

Abstract

Background: Primary soft tissue sarcomas of the chest wall are uncommon and data concerning treatment and results are sparse. We reviewed our experience with chest wall resections of these lesions.

Methods: Retrospective review of our database identified 25 patients (12 men, 13 women) who underwent chest wall resection for primary soft tissue sarcoma during the 18-year study period (January 1984 through to January 2002). The mean follow-up period was 46.5 months.

Results: The 30-day mortality was zero. The cumulative 5-year survival rate of all 25 patients was 56.9 %, and the median survival 99.5 months. This compared with 42.2 % and a median survival of 36.0 months after chest wall resection for high grade tumor histology. Histological type grading clearly influenced long-term survival ( P = 0.036). Local recurrence occurred in 9 patients, 6 of 8 who were resected with positive margins and 3 of 17 who were resected with negative margins. Chest wall resections extended with lung resections did not significantly impair postoperative pulmonary function compared to patients without concomitant lung resections.

Conclusions: Chest wall resections in primary soft tissue sarcomas can be accomplished safely with a low mortality rate. Long-term survival can be achieved for primary soft tissue sarcomas but histological grading is of prognostic significance.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Patient Selection
  • Retrospective Studies
  • Ribs / surgery
  • Sarcoma / mortality
  • Sarcoma / pathology
  • Sarcoma / physiopathology
  • Sarcoma / surgery*
  • Spirometry
  • Sternum / surgery
  • Surgical Flaps
  • Survival Analysis
  • Thoracic Neoplasms / mortality
  • Thoracic Neoplasms / pathology
  • Thoracic Neoplasms / physiopathology
  • Thoracic Neoplasms / surgery*
  • Thoracic Surgical Procedures* / adverse effects
  • Thoracic Wall / pathology*
  • Thoracic Wall / physiopathology
  • Thoracic Wall / surgery*
  • Treatment Outcome
  • Tumor Burden
  • Vital Capacity