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Surgical Treatment for Primary Chest Wall Sarcoma: A Single-Institution Study
Stéphane Collaud1, Theresa Stork1, Uta Dirksen2
1Department of Thoracic Surgery, Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), Center Essen, Essen, Germany.
The Journal of Surgical Research
|December 19, 2020
Summary
Complete surgical resection (R0) is key for survival in patients with primary chest wall sarcoma. Aggressive tumors require multimodal treatment, and extended resections are safe and feasible, improving outcomes.
Area of Science:
- Surgical Oncology
- Thoracic Surgery
- Sarcoma Research
Background:
- Primary chest wall sarcomas are rare and aggressive malignancies.
- Multimodal treatment, including surgery, is crucial for managing these tumors.
- Understanding prognostic factors is essential for optimizing patient outcomes.
Purpose of the Study:
- To describe the institutional patient cohort with primary chest wall sarcoma.
- To evaluate prognostic factors influencing survival and recurrence.
- To assess the safety and efficacy of surgical resection, including extended procedures.
Main Methods:
- Retrospective review of patients undergoing curative intent surgery for primary chest wall sarcoma (2004-2019).
- Assessment of prognostic variables: age, gender, resection type, tumor size, grade, stage, resection completeness, and neoadjuvant/adjuvant therapy.
- Survival analysis calculated from surgery date to last follow-up.
Main Results:
- Twenty-three patients (15 males, median age 54) were analyzed; chondrosarcoma was the most common histology (22%).
- R0 resection was achieved in 83% of cases, with 61% undergoing extended chest wall resection.
- Three- and 5-year overall survival rates were 53% and 35%; R0 resection predicted overall survival (P=0.029).
- Tumor grade and extended resections predicted recurrence (P=0.034 and P=0.018, respectively).
Conclusions:
- Surgical resection is a safe and effective treatment for primary chest wall sarcomas.
- Extended resections, when necessary, can be performed safely.
- Achieving complete tumor resection (R0) is a critical predictor of improved overall survival.
