Chest wall tumors. Experience with 100 consecutive patients

One hundred consecutive patients with chest wall tumors undergoing resection during the past 8 years were reviewed. There were 55 female and 45 male patients with ages ranging from 12 to 84 years (median 54.5 years). Fifty patients had primary malignant neoplasms, 32 had metastases, and 18 had benign tumors. The tumor was located in the ribs in 78 patients and in the sternum in 22. The number of ribs resected ranged from one to eight (median 3.4). Sternectomy was performed in 22 patients. Overlying soft tissue was resected en bloc in 47 patients. Reconstruction was with prosthetic material in 57 patients and autogenous ribs in 11. There were 100 muscle transpositions, including 45 pectoralis major, 33 latissimus dorsi, and 9 serratus anterior. Hospitalization ranged from 4 to 80 days (median 9.6 days). Complications occurred in nine patients. One patient required tracheostomy. There was one operative death. Median follow-up was 31.5 months. Recurrent tumor developed in seven patients. All patients with benign tumor and 95% of patients with primary tumor not previously treated were alive. However, only 41% of patients with metastatic tumor were alive. Metastases were responsible for 89% of late deaths. We conclude that aggressive resection for chest wall tumor with reliable reconstruction can be accomplished safely and that early wide resection is potentially curative treatment.