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

Abstract

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.

A Novel Four-Gene Prognostic Signature for Prediction of Survival in Patients with Soft Tissue Sarcoma

“…The underlying mechanism may be the resistant selection and disseminating cancer stem cells induced by chemotherapy at the site of the primary tumour, chemotherapy-induced recruitment of immune cells conducive to the dissemination of primary tumour cells, and mobilization/regulation of circulating tumour cell heterogeneity [ 42 , 43 , 44 , 45 ]. In terms of STS, in a recent study, researchers found that adjuvant chemotherapy was a poor prognostic factor for disease-free survival in chest wall STS patients (HR: 2.797; 95% CI: 1.057–3.409; p = 0.04), which was consistent with our results [ 46 ]. Meta-analyses also cannot prove the advantage of cytotoxic treatment in STS.…”

The application of three‐dimensional custom‐made prostheses in chest wall reconstruction after oncologic sternal resection

“…However, it is widely accepted that the clear margin and the grade of tumor are the vital factors related to longterm outcomes. [29][30][31] Limitations exist in this study. First, the current retrospective study was from a single center and had a small sample size.…”

“…At present, the diversity in histological types of the sternal tumor and the heterogeneity between literature are nonnegligible, there are no specific guidelines for the sternal tumor. However, it is widely accepted that the clear margin and the grade of tumor are the vital factors related to long‐term outcomes 29–31 …”

Practical Strategies in Reconstruction of Soft-Tissue Sarcoma

“…Histologic analysis has a variable distribution of subtypes of fibrosarcoma, malignant fibrous histiocytoma, chondrosarcoma, or potentially radiation-induced sarcomas such as angiosarcoma following treatment for breast cancer. 21,22 Soft-tissue coverage of the chest wall can be accomplished using a variety of different modalities. In circumstances where a suitable wound bed is present, a skin graft potentially represents the simplest approach, although this often results in a suboptimal cosmetic result with poor long-term durability, particularly in the setting of prior radiotherapy.…”