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Titolo:
A single-institutional, multidisciplinary approach to primary sarcomas involving the chest wall requiring full-thickness resections
Autore:
Walsh, GL; Davis, BM; Swisher, SG; Vaporciyan, AA; Smythe, WR; Willis-Merriman, K; Roth, JA; Putnam, JB;
Indirizzi:
Univ Texas, MD Anderson Canc Ctr, Dept Thorac & Cardiovasc Surg, Houston, TX 77030 USA Univ Texas Houston TX USA 77030 & Cardiovasc Surg, Houston, TX 77030 USA
Titolo Testata:
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
fascicolo: 1, volume: 121, anno: 2001,
pagine: 48 - 60
SICI:
0022-5223(200101)121:1<48:ASMATP>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
TUMORS; RECONSTRUCTION; MANAGEMENT; SURVIVAL; DIAGNOSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Walsh, GL Univ Texas, MD Anderson Canc Ctr, Dept Thorac & Cardiovasc Surg,1515 Holcombe,Box 109, Houston, TX 77030 USA Univ Texas 1515 Holcombe,Box 109 Houston TX USA 77030 77030 USA
Citazione:
G.L. Walsh et al., "A single-institutional, multidisciplinary approach to primary sarcomas involving the chest wall requiring full-thickness resections", J THOR SURG, 121(1), 2001, pp. 48-60

Abstract

Objective: Primary sarcomas involving the chest wall requiring full-thickness excision are rare. We reviewed our experience with these lesions in a tertiary referral cancer center by using multidisciplinary approaches. Methods: A 10-year retrospective study identified 51 patients referred with primary sarcomas of the chest wall: 40 for initial treatment and 11 afterprevious unsuccessful surgical excisions elsewhere (secondary referral). Presenting symptoms were pain alone in 23 (45%) of 51 patients, pain with anassociated mass in 8 (16%) patients, and an asymptomatic mass alone in 13 (25%) patients. Median symptom duration was 241 days in the primary group and 225 days in the recurrent group. Tumor locations were the sternum (n = 11), the rib alone (n = 36), and the posterior rib with extension into vertebral bodies (n = 4). Histologic types included the following: chondrosarcomas (n = 15), malignant fibrous histiocytomas (n = 9), osteosarcomas (n = 4), Ewing sarcomas (n = 3), desmoid tumors (n = 7), and other types (n = 13). The median tumor volume of those referred initially was 311 cm(3) comparedwith 84 cm(3) in patients with recurrent lesions. Results: Twenty-six (51%) of 51 patients received treatment before resection, including chemotherapy alone (n = 22), radiation alone (n = 3), and combined chemotherapy and radiation therapy (n = 1). The complete sternum was removed in 6 of 11 patients, and the average number of ribs requiring resection was 3.8. Four patients had vertebral body resections. Prosthetic meshes alone were required in 16 of 51 patients, and meshes with methylmethacrylate were required in 18 of 51 patients. Muscle flap reconstructions by plastic surgery were required in 24 patients. Negative margins were obtained in47 of 51 patients. There were no perioperative deaths with morbidities occurring in 12 (24%) of 51 patients (wound [n = 3], prolonged air leak [n = 1], prolonged ventilator requirement [n = 1], arrhythmias [n = 3], doxorubicin (Adriamycin)-induced cardiomyopathy [n = 1], and other [n = 3]). Postoperative treatment was administered to 13 patients (chemotherapy alone, n = 9; chemotherapy with radiation therapy, n = 4). The cumulative 5-year survival of all patients was 64% (initial referral, 61.3%; secondary referral, 72.7%). The average follow-up is 44.7 months. Conclusions: A combined aggressive multidisciplinary approach to primary sarcomas of the chest wall resulted in no treatment-related deaths and a cumulative 5-year survival of 64% in patients referred to our tertiary care cancer center.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/09/20 alle ore 00:17:34