Related Experiment Video
Updated: Mar 10, 2026
Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
Published on: April 19, 2024
Outcomes of chest wall resections in pediatric sarcoma patients
Carmen Lopez1, Arlene Correa1, Ara Vaporciyan1
1MD Anderson Cancer Center, Houston, TX.
Insights
Pediatric chest wall sarcomas treated with resection show that tumor histology, rib location, and surgical margins affect survival. Scoliosis is more common with posterior rib resections, but reconstruction type does not impact outcomes.
Area of Science:
- Pediatric oncology
- Surgical oncology
- Thoracic surgery
Background:
- Chest wall tumors in children are rare but can be aggressive.
- Sarcomas are a significant cause of pediatric chest wall malignancies.
Purpose of the Study:
- To evaluate outcomes in pediatric patients undergoing chest wall resection for sarcomas.
- To identify factors influencing survival and complications in this cohort.
Main Methods:
- Retrospective review of patients under 19 years old treated for sarcoma from 1999-2014.
- Analysis of surgical techniques, reconstruction methods, and patient outcomes.
Main Results:
- Ewing's sarcoma and osteosarcoma were the most common types.
- Tumor histology, rib location, and surgical margins significantly impacted overall survival.
- Scoliosis developed in 11.4% of patients, primarily those with posterior rib tumors.
Conclusions:
- Scoliosis is more prevalent following posterior rib resections.
- While histology, tumor location, and margins are critical for survival, the reconstruction method does not appear to influence outcomes.
Purpose:
Chest wall tumors in pediatric patients are rare. This study evaluates outcomes in pediatric patients who have undergone chest wall resections secondary to sarcomas.
Methods:
A retrospective review was performed for patients <19years old who underwent chest wall resections for sarcoma 1999-2014 at the University of Texas MD Anderson Cancer Center.
Results:
Of 44 patients, Ewing's sarcoma (n=18) and osteosarcoma (n=16) were most common. Other sarcomas included synovial sarcoma, chondrosarcoma, and rhabdomyosarcoma. Gore-Tex® or a Marlex™ mesh and methyl methacrylate sandwich was used in 22 patients, and 9 children did not require reconstruction. Twenty-four (54.5%) patients had normal activity, 3 (6.8%) had occasional discomfort, 2 (4.5%) had pain impairing function, 7 (15.9%) required medication or physical therapy for impairment, and 8 (18.2%) needed additional surgery. Five children (11.4%) developed scoliosis, and all of these patients had posterior rib tumors. Median overall survival for the entire cohort was 41.9±11.82months. Histology (p=0.003), location of tumor on the ribs (p=0.007), and surgical margins (p=0.011) were significantly associated with overall survival. Tumors on the middle and posterior (p=0.003) portions of the ribs had a lower chance of death.
Conclusion:
Scoliosis is more common in posterior rib resections. Histology, location of the tumor, and surgical margins impact survival, but, type of reconstruction does not.
Level Of Evidence:
III.
Type Of Study:
Treatment Study.
Related Concept Videos
01:27Pneumothorax-II
Clinical Manifestations:
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History: