Invited Commentary on “Thoraco-pleuro-pneumonectomy (TPP) with Riblike Reconstruction for Recurrent Thoracic Sarcomas” by A. Gronchi et al., (ASO-2013-09-1533.R1)

Excerpt

The authors’ solution for recurrent advanced low-intermediate grade thoracic sarcomas is interesting, promising, and unique. As stated, there are no other reported interventions of this scale. The organic shape and fluid kinetics of the thorax are critical to its function. Previous attempts at lesser resections of the chest wall have been successful when combined with reconstruction. For the reconstruction, surgeons have used muscle, autologous bone, biologic mesh, synthetic mesh, and synthetic sternal shields to try and attain the perfect balance of rigidity and pliability to most accurately reflect normal chest physiology.1 This paper increases the definition of resectability and expands the methods or reconstruction and hence the boundaries of potential cure for large low-grade chest wall sarcomas. …