Predictors of survival after resection of primary sarcomas of the chest wall—A large, single‐institution series

Shewale, Jitesh B.; Mitchell, Kyle G.; Nelson, David B.; Conley, Anthony P.; Rice, David C.; Antonoff, Mara B.; Hofstetter, Wayne L.; Walsh, Garrett L.; Swisher, Stephen G.; Roth, Jack A.; Mehran, Reza J.; Vaporciyan, Ara A.; Weissferdt, Annikka; Sepesi, Boris

doi:10.1002/jso.25162

Cited by 22 publications

(22 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There have been several analyses of prognostic factors in patients with STS; however, the majority of these reports have been limited by heterogeneous patient cohorts and small patient sample sizes. Furthermore, these reports have included patients with a variety of histologic tumor types, as well as those with low‐grade sarcomas and chest wall bone tumors, the latter of which exhibit clinical behaviors that differ from those of STS. Therefore, in the current study, we sought to investigate the treatment outcomes of primary chest wall STS patients, excluding those diagnosed with bone sarcomas, and to identify factors that influence patient prognosis.…”

Section: Introductionmentioning

confidence: 99%

Treatment outcome of chest wall soft tissue sarcomas: Analysis of prognostic factors

Nakahashi

Emori

Tsuchie

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background: Primary soft tissue sarcomas (STSs) involving the chest wall are uncommon. The aim of this study was to identify factors that influence the prognosis of patients with primary chest wall STS. Methods: The records of 38 patients (23 men and 15 women) who were treated at our institutions during 2002 to 2018 were reviewed. The following variables were evaluated as potential prognostic factors: sex, tumor size, chemotherapy, and completeness of surgical margins. Multivariate analysis was conducted to identify predictors of overall survival (OS) and disease-free survival (DFS). Results: Of the 38 included patients, 5 had low-grade tumors and 33 had high-grade tumors. Five patients required chest wall reconstruction including rib resection. Thirty patients (79%) underwent R0 resection. The 5-year OS and DFS rates were 45% and 27%, respectively. Local recurrence developed in 7 patients. Multivariate analysis identified tumor size (hazard ratio [HR]: 4.13; 95% confidence interval [CI]: 1.05-16.24; P = .04) and R1/2 resection (HR: 3.92; 95% CI: 1.12-13.66; P = .03) as predictors of OS. Conclusions: Prognostic factors for survival included tumor size and completeness of surgical margins. Complete tumor excision is desirable, particularly in cases of early detection.

show abstract

Section: Introductionmentioning

confidence: 99%

Treatment outcome of chest wall soft tissue sarcomas: Analysis of prognostic factors

Nakahashi

Emori

Tsuchie

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…Once this evaluation is complete considerations regarding the resectability of the tumor and the need for neoadjuvant therapy are made. Important factors influencing the design of the treatment plan include tumor histology, grade and size, the potential to achieve clear surgical margins and the general health status of the patient [10][11][12][13][14]. Overall, we performed 28 surgeries on 25 patient.…”

Section: Discussionmentioning

confidence: 99%

“…Keeping in mind that achieving clear resection margins remains the key goal of surgery for chest wall sarcomas, we argue that it is important in the preoperative planning to thoroughly consider the desired extent of resection, and also to prepare for the appropriate reconstructive steps [2,[4][5][6][7][10][11][12][13][14]. Overall, in the current series, we have applied an aggressive surgical resection approach.…”

Section: Discussionmentioning

confidence: 99%

11-year experience with Chest Wall resection and reconstruction for primary Chest Wall sarcomas

Wald

Islam

Korach

et al. 2020

J Cardiothorac Surg

View full text Add to dashboard Cite

Background & Objectives: Primary chest wall sarcomas are rare and therapeutically challenging tumors. Herein we report the outcomes of a surgery-based multimodality therapy for these pathologies over an 11-year period. In addition, we present a case that illustrates the surgical challenges that extensive chest wall resection may pose. Methods: Using the Society of Thoracic Surgeons general thoracic surgery database, we have prospectively collected data in our institute on all patients undergoing chest wall resection and reconstruction for primary chest wall sarcomas between June 2008-October 2019. Results: We performed 28 surgical procedures on 25 patients aged 5 to 91 years (median age 33). Eleven tumors were bone-and cartilage-derived and 14 tumors originated from soft tissue elements. Seven patients (7/25, 28%) received neo-adjuvant therapy and 14 patients (14/25, 56%) received adjuvant therapy. The median number of ribs that were resected was 2.5 (range 0 to 6). In 18/28 (64%) of surgeries, additional skeletal or visceral organs were removed, including: diaphragm [1], scapula [2], sternum [2], lung [2], vertebra [1], clavicle [1] and colon [1]. Chest wall reconstruction was deemed necessary in 16/28 (57%) of cases, polytetrafluoroethylene (PTFE) Gore-Tex patches was used in 13/28 (46%) of cases and biological flaps where used in 4/28 (14%) of cases. R0, R1 and R2 resection margins were achieved in 19/28 (68%), 9/28 (32%) and 0/28 (0%) of cases, respectively. The median follow up time was 33 months (range 2 to 138). During the study period, disease recurred in 8/25 (32%) of patients. Of these, 3 were re-operated on and are free of disease. At date of last follow up, 5/25 (20%) of patients have died due to their disease and in contrast, 20/25 (80%) were alive with no evidence of disease. Conclusions: Surgery-based multimodality therapy is an effective treatment approach for primary chest wall sarcomas. Resection of additional skeletal or visceral organs and reconstruction with synthetic and/or biological flaps is often required in order to obtain R0 resection margins. Ultimately, long-term survival in this clinical scenario is an achievable goal.

show abstract

“…However, tumors could be impossible to cure with free margins because they may touch major vessels or be an unresectable structure. Local recurrence risk after surgical resection is related to the presence or absence of margin involvement where a positive margin on a critical structure is a common situation, mainly for retroperitoneal sarcoma [26,27]. Local treatment after surgery can be modeled using multilayered nanofilms to increase the rate of tumor control.…”

Section: Discussionmentioning

confidence: 99%

Multi-nanolayer drug delivery using radiofrequency plasma technology

et al. 2020

View full text Add to dashboard Cite

Background: It may be impossible to perform cancer surgery with free margins in the presence of an unresectable structure. Local drug treatment after surgery has been proposed to increase the rate of tumor control. Methods: Multi-nanolayers (10-330 nm) were generated by a low-pressure (375mTorr) inductively coupled plasma (13.56 MHz) reactor for anticancer drug delivery by the deposition of polycaprolactone-polyethylene glycol multistack barrier on the collagen membrane (100 μm thickness). Carboplatin (300 μg/cm 2) was used for the in vitro and in vivo investigations. Energy-dispersive X-ray spectroscopy (15 keV), scanning electron microscopy and inductively coupled plasma mass spectrometry were used to detect the presence of carboplatin in the nanolayer, the tumor sample and the culture medium. Preclinical studies were performed on ovarian (OVCAR-3NIH) and colon (CT26) cancer cell lines as xenografts (45 days) and allografts (23 days) in Swiss-nude (n = 6) and immunocompetent BALB/cByJ mice (n = 24), respectively. Results: The loading of carboplatin or other drugs between the nanofilm on the collagen membrane did not modify the mesh complex architecture or the drug properties. Drugs were detectable on the membrane for more than 2 weeks in the in vitro analysis and more than 10 days in the in vivo analysis. Cytotoxic mesh decreased cell adherence (down 5.42-fold) and induced cancer cell destruction (up to 7.87-fold). Implantation of the mesh on the mouse tumor nodule modified the cell architecture and decreased the tumor size (50.26%) compared to the control by inducing cell apoptosis. Conclusion: Plasma technology allows a mesh to be built with multi-nanolayer anticancer drug delivery on collagen membranes.

show abstract

Predictors of survival after resection of primary sarcomas of the chest wall—A large, single‐institution series

Abstract: In this series of resected chest wall sarcomas, complete resection and tumor grade remain the most important survival predictors. Individual decisions are required for the utilization of neoadjuvant therapy.

Cited by 22 publications

References 18 publications

Treatment outcome of chest wall soft tissue sarcomas: Analysis of prognostic factors

Treatment outcome of chest wall soft tissue sarcomas: Analysis of prognostic factors

11-year experience with Chest Wall resection and reconstruction for primary Chest Wall sarcomas

Multi-nanolayer drug delivery using radiofrequency plasma technology

Contact Info

Product

Resources

About