Clinical outcomes and complications associated with surgical resection of chest wall sarcoma

Chest wall sarcomas are rare malignant mesenchymal tumors arising from soft tissue, cartilage and bones. Wide resection is usually the treatment option but often results in postoperative complications after resection of the chest wall. In this study, we reviewed cases of chest wall sarcoma treated with resection of the sternum or ribs and examined the factors that could cause complications.

We enrolled consecutive patients with sarcoma who underwent chest wall surgery with resection of the sternum or ribs between January 2007 and October 2022. We collected data on age, sex, tumor location and size, histology, and detailed resection data of the lung, diaphragm, ribs, sternum, and postoperative complications.

Seventy-one patients were included in the study. The 5-year overall survival and disease-free survival rates were 76.8% and 56.8%, respectively. Age ≤ 63 years was associated with poor disease-free survival (p = 0.019) in the multivariate analysis. Nineteen patients (26.7%) had postoperative complications such as surgical site infections and respiratory disorders. None of the patients died after surgery. Resection of 4 or more ribs was positively correlated with the occurrence of complications (p = 0.040), with an occurrence rate of 45%.

The current study is one of the largest to focus on postoperative complications associated with surgery for chest wall sarcoma with resection of the ribs or sternum. This study suggests that careful postoperative management is advisable when 4 or more ribs are resected during surgery for chest wall sarcoma.