Background: Primary chest wall sarcomas are a rare and heterogeneous group of chest wall tumors that require multimodal oncologic and surgical therapy. The aim of this study was to review our experience regarding the surgical treatment of chest wall sarcomas, evaluating the short- and long-term results. Methods: In this retrospective single-center study, patients who underwent surgery for soft tissue and bone sarcoma of the chest wall between 1999 and 2018 were included. We analyzed the oncologic and surgical outcomes of chest wall resections and reconstructions, assessing overall and recurrence-free survival and the associated clinical factors. Results: In total, 44 patients underwent chest wall resection for primary chest wall sarcoma, of which 18 (41%) received surgery only, 10 (23%) received additional chemoradiotherapy, 7% (3) received surgery with chemotherapy, and 30% (13) received radiotherapy in addition to surgery. No perioperative mortality occurred. Five-year overall survival was 51.5% (CI 95%: 36.1–73.4%), and median overall survival was 1973 days (CI 95% 1461; -). As determined in the univariate analysis, the presence of metastasis upon admission and tumor grade were significantly associated with shorter survival (p= 0.037 andp< 0.01, respectively). Five-year recurrence-free survival was 71.5% (95% CI 57.6%; 88.7%). Tumor resection margins and metastatic disease upon diagnosis were significantly associated with recurrence-free survival (p< 0.01 andp< 0.01, respectively). Conclusion: Surgical therapy is the cornerstone of the treatment of chest wall sarcomas and can be performed safely. Metastasis and high tumor grade have a negative influence on overall survival, while tumor margins and metastasis have a negative influence on local recurrence.
背景：原发性胸壁肉瘤是一类罕见且异质性的胸壁肿瘤，需要多模式肿瘤学与外科治疗。本研究旨在回顾我们关于胸壁肉瘤外科治疗的经验，评估其短期与长期疗效。 方法：在这项回顾性单中心研究中，纳入了1999年至2018年间因胸壁软组织及骨肉瘤接受手术的患者。我们分析了胸壁切除与重建手术的肿瘤学及外科结局，评估了总生存期、无复发生存期及相关临床因素。 结果：共有44例原发性胸壁肉瘤患者接受了胸壁切除术，其中18例（41%）仅接受手术治疗，10例（23%）接受了额外的放化疗，7%（3例）接受了手术联合化疗，30%（13例）在手术基础上接受了放疗。围手术期无死亡病例。五年总生存率为51.5%（95%置信区间：36.1–73.4%），中位总生存期为1973天（95%置信区间：1461；-）。单因素分析显示，入院时存在转移灶和肿瘤分级与较短的生存期显著相关（p值分别为0.037和<0.01）。五年无复发生存率为71.5%（95%置信区间：57.6%–88.7%）。肿瘤切除边缘状态和确诊时转移性疾病与无复发生存期显著相关（p值均<0.01）。 结论：外科治疗是胸壁肉瘤治疗的基石，可安全实施。转移灶和高肿瘤分级对总生存期有负面影响，而肿瘤切缘状态和转移灶对局部复发有负面影响。
Outcome Analysis of Treatment Modalities for Thoracic Sarcomas
肿瘤(癌症)患者之家