Management of chest wall tumors: 15 years clinical experience, a retrospective study of 52 patients

Main Article Content

Vinicius Basso Preti http://orcid.org/0000-0002-7574-6611 Gerardgo C.G. Valladaress Tariane F. Foiato Jessica Takaki

Abstract

ABSTRACT

 

Introduction: Primary chest wall tumors are rare and it is more common originated from bone and cartilage tissue. The clinical manifestation is nonspecific. The main complaint is the pain but generally vague and fails to characterize a specific type or location and early diagnosis is compromised.

Objective:  Evaluation of patients with thoracic wall tumors submitted to surgical treatment at a tertiary hospital for oncological care.

Methods: Retrospective study of 52 cases, between 1998 and 2013.

Results: There was a predominance of males, corresponding to 58% of the cases. The main histological types were osteosarcoma, Schwanomma and immature teratoma. Of the 52 cases, 5 of them were direct extension or metastasis of other sites that had as their first manifestation of the disease the mass of the chest wall. The main therapeutic modality was isolated surgery. The type of reconstruction most used to close the surgical defect was the first intention closure used in 25 patients, followed by the myocutaneous flap in 22 patients. The 5-year survival status of this population were 34.6% of the patients alive but alive with active disease in 13.4% of the sample.

Conclusion: Radical resection associated with reconstruction techniques allowed an increase in survival time. The priority is restoration of structural and functional integrity of the chest, work has been done to find ways of approach that combine a better chance of cure of the disease and a satisfactory quality of life for patients.

Article Details

How to Cite
PRETI, Vinicius Basso et al. Management of chest wall tumors: 15 years clinical experience, a retrospective study of 52 patients. Medical Research Archives, [S.l.], v. 5, n. 6, june 2017. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/1338>. Date accessed: 29 mar. 2024.
Keywords
Chest wall tumor; thoracic surgery; chest wall reconstruction
Section
Case Reports

References

. Shah AA, D’Amico TA. Primary Chest Wall Tumors. J Am Coll Surg [Internet]. Elsevier Inc.; 2010;210(3):360–6. Available from http://linkinghub.elsevier.com/retrieve/pii/S1072751509016123

2. Hsu P-K, Lee H-C, Hsieh C-C, Wu Y-C, Wang L-S, Huang B-S, et al. Management of Primary Chest Wall Tumors: 14 Years’ Clinical Experience. J Chinese Med Assoc [Internet]. Elsevier; 2006;69(8):377–82. Available at: http://dx.doi.org/10.1016/S1726-4901(09)70276-X

3. D’Alessandro P, Carey-Smith R, Wood D. Large resection and reconstruction of primary parietal thoracic sarcoma: A multidisciplinary approach on 11 patients at minimum 2-years follow-up. Orthop Traumatol Surg Res [Internet]. Elsevier Masson SAS; 2011;97(1):73–8. Available at: http://dx.doi.org/10.1016/j.otsr.2010.09.014

4. Leuzzi G, Nachira D, Cesario A, Novellis P, Ciavarella LP, Lococo F, et al. Chest wall tumors and prosthetic reconstruction: A comparative analysis on functional outcome. Thorac Cancer. 2015;6(3):247–54.

5. Bagheri R, Haghi SZ, Kalantari MR, Attar AS, Salehi M, Tabari A, et al. Primary malignant chest wall tumors: analysis of 40 patients. J Cardiothorac Surg [Internet]. 2014;9(1):106. Available at: http://www.cardiothoracicsurgery.org/content/9/1/106

6. Ferraro P, Cugno S, Liberman M, Danino MA, Harris PG. Principles of chest wall resection and reconstruction. Thorac Surg Clin [Internet]. Elsevier Ltd; 2010;20(4):465–73. Available at: http://dx.doi.org/10.1016/j.thorsurg.2010.07.008

7. Koenigkam-Santos M, Sommer G, Puderbach M, Safi S, Schnabel PA, Kauczor H-U, et al. Primary intrathoracic malignant mesenchymal tumours: computed tomography features of a rare group of chest neoplasms. Insights Imaging [Internet]. 2014;5:237–44. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3999366&tool=pmcentrez&rendertype=abstract

8. Kucharczuk JC. Chest Wall Sarcomas and Induction Therapy. Thorac Surg Clin [Internet]. Elsevier Inc; 2012;22(1):77–81. Available at: http://dx.doi.org/10.1016/j.thorsurg.2011.08.015

9. Yang H, Tantai J, Zhao H. Clinical experience with titanium mesh in reconstruction of massive chest wall defects following oncological resection. J Thorac Dis. 2015;7(7):1227–34.

10. A reconstructive algorithm for plastic surgery following extensive chest wall resection Losken A., Thourani V.H., Carlson G.W., Jones G.E., Culbertson J.H., Miller J.I., Mansour K.A. (2004) British Journal of Plastic Surgery, 57 (4) , pp. 295-302.

11. Van Geel AN, Wouters MWJM, Lans TE, Schmitz PIM, Verhoef C. Chest wall resection for adult soft tissue sarcomas and chondrosarcomas: Analysis of prognostic factors. World J Surg. 2011;35:63–9.

12. Kachroo P, Pak PS, Sandha HS, Lee C, Elashoff D, Nelson SD, et al. Single-Institution, Multidisciplinary Experience with Surgical Resection of Primary Chest Wall Sarcomas. J Thorac Oncol. 2012;7(3):552–8.

13. Wouters MW, Van Geel AN, Nieuwenhuis L, Van Tinteren H, Verhoef C, Van Coevorden F, et al. Outcome after surgical resections of recurrent chest wall sarcomas. J Clin Oncol. 2008;26(31):5113–8.

14. McMillan RR, Sima CS, Moraco NH, Rusch VW, Huang J. Recurrence patterns after resection of soft tissue sarcomas of the chest wall. Ann Thorac Surg [Internet]. Elsevier Inc; 2013;96(4):1223–8. Available at: http://dx.doi.org/10.1016/j.athoracsur.2013.05.015