Mini review: surgical management of primary chest wall tumors

Ito, Takamasa; Suzuki, Hidemi; Yoshino, Ichiro

doi:10.1007/s11748-016-0719-z

Cited by 10 publications

(14 citation statements)

References 39 publications

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“…In children, Ewing's sarcoma is the most common chest wall tumor; while in adults chondrosarcoma predominates (2,15,16). In our study the figure for adult was confirmed and chondrosarcoma was found to be the most predominant pathological subtype.…”

Section: Discussionsupporting

confidence: 74%

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Contributing factors to the outcome of primary malignant chest wall tumors

et al. 2017

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Background: Primary malignant chest-wall tumors (PMCWTs) are a heterogeneous group of tumors.They require a special experience in designing resection and reconstruction. They account for less than 1% of all primary malignant tumors. This study is designed to clarify different factors contributing to the outcome of patients with PMCWTs in our institution. Methods: A retrospective study included 98 patients with pathology proven PMCWTs, treated at the National Cancer Institute (NCI), Cairo University, Egypt, during the past 10 years.

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Section: Discussionsupporting

confidence: 74%

“…Primary malignant chest wall tumors are a heterogeneous group of tumors that originate from thoracic soft tissue and skeletal structures (1,2).…”

Section: Introductionmentioning

confidence: 99%

Contributing factors to the outcome of primary malignant chest wall tumors

et al. 2017

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“…Primary malignant tumors of the chest wall are rare (only about 1% of all primary tumors), but chondrosarcomas represent the most frequent histological type (6,7,(10)(11)(12). The ribs are thought to be more frequently affected than the sternum (6,7,11,(13)(14)(15). Likewise, in our study 36 patients (68%) had costal chondrosarcoma, 13 patients (24.5%) chondrosarcoma of the sternum and only four patients…”

Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Chondrosarcoma of the Chest Wall: A Review of 53 Cases from Two Institutions

et al. 2020

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Background/Aim: Chondrosarcomas (CS) of the chest wall are rare, but present an aggressive biological behavior compared to CS of the extremities. The aims of the present study were to determine factors associated with oncological outcomes as well as complications. Patients and Methods: We retrospectively analyzed 53 patients (42 primary, 11 recurrent tumors). In total, 39 central CS, 10 peripheral CS, 3 dedifferentiated CS and 1 mesenchymal CS were included. The ribs were most commonly affected (68%). Overall survival and disease-free survival were estimated with Kaplan-Meier analyses and compared with log-rank test. Results: Mean follow-up was 7 years. Negative margins were achieved in 87% of patients. Thirty patients (57%) remained continuously disease-free (NED), three (5%) NED after treatment of relapse, seven (13%) were alive with disease, twelve (23%) were dead with disease and one of other cause. The 10-year survival rate was 81% and 45% in primary and recurrent tumors, respectively. Survival was significantly affected by tumor stage (p<0.001), local recurrence (p=0.025) and metastases (p=0.002). Six complications (16%) were observed. Conclusion: The outcome is rather poor, especially in patients with local recurrence. Presumably due to a high biological aggressiveness, a stricter definition of surgical margins should be considered for this location.Chondrosarcomas account for about 20% of all primary malignant osseous tumors, representing the third most common primary malignancy of bone after myeloma and osteosarcoma (1, 2). They are most frequently located in the pelvis (ilium), followed by proximal femur, proximal humerus and distal femur (3, 4). The chest wall (primarily the ribs) is affected in about 15% of cases, and thus the annual incidence is extremely low for this manifestation site (5, 6). However, chondrosarcoma represents the most common primary bone tumor involving the ribs and sternum (7). Tumor-related factors, such as tumor grade and localization, have been shown to be independent predictors of chondrosarcoma patient survival (3). The rate of metastases has been also found higher in pelvic and chest wall chondrosarcomas, compared to conventional chondrosarcomas of the extremities (8). Thus, involvement of pelvis and chest wall have been associated with a poorer outcome. Particular characteristics of chest wall chondrosarcoma, like its close proximity to vital organs, its indolent nature, and the high risk of local recurrence have been further emphasized (5,8,9).Published studies on the outcome and prognostic factors of the patients with chondrosarcomas of the chest wall are relatively limited (5-15). Therefore, we performed this study to evaluate the distribution patterns, natural history and tumor-related data of patients with chondrosarcoma of the chest wall, and analyze patients' outcome with respect to survival and complications after surgical treatment. Patients and MethodsWe retrospectively studied all patients with histologically documented chondrosarcomas of the chest wall (sternum...

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“…Amongst sarcomas, those arising from the chest wall account for less than 20%, with the majority arising in the peripheral extremities. Chest wall sarcomas may be classified as either hard or soft tissue tumours based on their tissue of origin, and approximately 50%–80% of these tumours are malignant 1 . As is the general rule for extremity sarcomas, surgical resection of chest wall sarcomas is considered the cornerstone of curative treatment.…”

Section: Introductionmentioning

confidence: 99%

Surgical resection of chest wall sarcomas: an analysis of survival and predictors of outcome at an Australian multidisciplinary sarcoma service

Thakur

Choong

Balasooriya

et al. 2022

ANZ Journal of Surgery

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Background: Chest wall sarcomas are a rare group of tumours. Surgical resection is considered the mainstay of curative treatment, however, resection and reconstruction of chest wall defects presents complex issues for the clinician. Methods: A retrospective analysis of 59 patients undergoing surgical management of chest wall sarcoma between December 1996 and July 2020 was conducted across a multidisciplinary sarcoma service in Melbourne, Australia. Patient demographics, pathologic data, and long-term outcomes were recorded. Results: Mean age at surgery was 48.4 years (SD 18.3), and 66.1% were male. Median follow-up was 29 months (IQR 11.8, 51.0 months). Fifty-one patients presented with primary tumours, while the others had secondary tumours resected. Most tumours arose in bone (72.9%) as opposed to soft tissues (27.1%). Chondrosarcoma was the most common histologic subtype (50.8%). The most common reconstructive techniques involved the use of mesh (79.7%) or mesh supplemented with bone cement (33.9%). Overall survival at 1 and 5 years was 92% and 70%, respectively. Seven patients died of metastatic sarcoma during the follow up period with a median survival time of 27 months. Twelve patients had evidence of disease recurrence during the follow-up period. Stage 4 disease, soft tissue tumours, secondary tumours, leiomyosarcoma and UPS subtypes, and plating reconstruction were associated with increased disease recurrence. Conclusions: The results suggest that outcomes for chest wall sarcoma are similar to extremity sarcomas and may be treated in a similar manner. Patients requiring adjuvant radiotherapy and those who develop disease-recurrence are more likely to have worse overall survival outcome despite complete surgical resection.

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Mini review: surgical management of primary chest wall tumors

Cited by 10 publications

References 39 publications

Contributing factors to the outcome of primary malignant chest wall tumors

Contributing factors to the outcome of primary malignant chest wall tumors

Chondrosarcoma of the Chest Wall: A Review of 53 Cases from Two Institutions

Surgical resection of chest wall sarcomas: an analysis of survival and predictors of outcome at an Australian multidisciplinary sarcoma service

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