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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2024

28-12-2023 | Radiotherapy | Reconstructive Oncology

Malignant Chest Wall Tumors: Complex Defects and Their Management—A Review of 181 Cases

Authors: Jyoti Sharma, MCh, S. V. S. Deo, MS, Sunil Kumar, MS, Sandeep Bhoriwal, MCh, Naveen Gupta, MCh, Jyoutishman Saikia, MCh, Sushma Bhatnagar, MD, Seema Mishra, MD, Sachidanand Bharti, MD, Sanjay Thulkar, MD, Sameer Bakhshi, DM, D. N. Sharma, MD

Published in: Annals of Surgical Oncology | Issue 6/2024

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Abstract

Background

Chest wall tumors are a heterogeneous group of tumors that are managed by surgeons from diverse specialties. Due to their rarity, there is no consensus on their diagnosis and management.

Materials

This retrospective, descriptive analysis includes patients with malignant chest wall tumors undergoing chest wall resection. Tumors were classified as primary, secondary, and metastatic tumors. The analysis includes clinicopathological characteristics, resection-reconstruction profile, and relapse patterns.

Results

A total of 181 patients underwent chest wall resection between 1999 and 2020. In primary tumors (69%), the majority were soft tissue tumors (59%). In secondary tumors, the majority were from the breast (45%) and lung (42%). Twenty-five percent of patients received neoadjuvant chemotherapy, and 98% of patients underwent R0 resection. Soft tissue, skeletal + soft tissue, and extended resections were performed in 45%, 70%, and 28% of patients, respectively. The majority of patients (60%) underwent rib resections, and a median of 3.5 ribs were resected. The mean defect size was 24 cm2. Soft tissue reconstruction was performed in 40% of patients, mostly with latissimus dorsi flaps. Rigid reconstruction was performed in 57% of patients, and 18% underwent mesh-bone cement sandwich technique reconstruction. Adjuvant radiotherapy and chemotherapy were given to 29% and 39% of patients, respectively.

Conclusions

This is one of the largest single-institutional experiences on malignant chest wall tumors. The results highlight varied tumor spectra and multimodality approaches for optimal functional and survival outcomes. In limited resource setting, surgery, including reconstructive expertise, is very crucial.
Appendix
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Metadata
Title
Malignant Chest Wall Tumors: Complex Defects and Their Management—A Review of 181 Cases
Authors
Jyoti Sharma, MCh
S. V. S. Deo, MS
Sunil Kumar, MS
Sandeep Bhoriwal, MCh
Naveen Gupta, MCh
Jyoutishman Saikia, MCh
Sushma Bhatnagar, MD
Seema Mishra, MD
Sachidanand Bharti, MD
Sanjay Thulkar, MD
Sameer Bakhshi, DM
D. N. Sharma, MD
Publication date
28-12-2023
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-14765-w

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