Surgical resection of chest wall sarcomas: an analysis of survival and predictors of outcome at an Australian multidisciplinary sarcoma service

Thakur, S; Choong, E; Balasooriya, A; Spelman, T; Wright, G; Choong, P

Author(s): Thakur, S; Choong, E; Balasooriya, A; Spelman, T; Wright, G; Choong, P;
Details: Publication Year 2022-10,Volume 92,Issue #10,Page 2613-2619
Journal Title: ANZ Journal of Surgery
Publication Type: Research article
Abstract: BACKGROUND: Chest wall sarcomas are a rare group of tumours. Surgical resection is considered the mainstay of curative treatment, however, resection and reconstruction of chest wall defects presents complex issues for the clinician. METHODS: A retrospective analysis of 59 patients undergoing surgical management of chest wall sarcoma between December 1996 and July 2020 was conducted across a multidisciplinary sarcoma service in Melbourne, Australia. Patient demographics, pathologic data, and long-term outcomes were recorded. RESULTS: Mean age at surgery was 48.4 years (SD 18.3), and 66.1% were male. Median follow-up was 29 months (IQR 11.8, 51.0 months). Fifty-one patients presented with primary tumours, while the others had secondary tumours resected. Most tumours arose in bone (72.9%) as opposed to soft tissues (27.1%). Chondrosarcoma was the most common histologic subtype (50.8%). The most common reconstructive techniques involved the use of mesh (79.7%) or mesh supplemented with bone cement (33.9%). Overall survival at 1 and 5 years was 92% and 70%, respectively. Seven patients died of metastatic sarcoma during the follow up period with a median survival time of 27 months. Twelve patients had evidence of disease recurrence during the follow-up period. Stage 4 disease, soft tissue tumours, secondary tumours, leiomyosarcoma and UPS subtypes, and plating reconstruction were associated with increased disease recurrence. CONCLUSIONS: The results suggest that outcomes for chest wall sarcoma are similar to extremity sarcomas and may be treated in a similar manner. Patients requiring adjuvant radiotherapy and those who develop disease-recurrence are more likely to have worse overall survival outcome despite complete surgical resection.
Keywords: Australia/epidemiology; Bone Cements; *Bone Neoplasms/pathology/surgery; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local/pathology; *Plastic Surgery Procedures/methods; Retrospective Studies; *Sarcoma/pathology; *Soft Tissue Neoplasms/pathology/surgery; *Thoracic Neoplasms/pathology/surgery; *Thoracic Wall/pathology/surgery; chest wall; oncology; sarcoma; thoracic surgery
Department(s): Surgical Oncology
PubMed ID: 35818677
Publisher's Version: https://doi.org/10.1111/ans.17904
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-04-17 07:51:21

Last Modified: 2025-04-17 07:51:48