title: Surgical treatment of primary and metastatic sternal tumours.
abstract: BACKGROUND
  Primary and metastatic malignancies of the sternum are uncommon. Surgery that is the best treatment for the majority of primary sternal tumors, and arguably for metastatic lesions, has improved permitting us to perform wide resection and simultaneous reconstruction safely.
  
  
  METHODS
  From January 1988 to December 1998 we treated 13 patients, 4 with primary chondrosarcoma and 9 with sternal metastasis, 5 breast cancer, 3 kidney cancer and 1 thyroid cancer. In 3 patients total sternectomy was performed and in 10 a partial sternectomy associated with resection of the anterior segment of the ribs in 7 cases and resection of the clavicle in 5 patients. Bone reconstruction was done in the majority of cases (5) with Marlex mesh with methylmethacrylate and in 3 cases rib grafts were used to strengthen a Vicryl mesh. The major pectoralis muscle was the most frequently used soft tissue, 9 of 12.
  
  
  RESULTS
  Our postoperative mortality was 15%, 2 cases. The median overall survival was 48 months. All the primary tumours were alive after a mean follow-up of 34 months (range 4-84 months). While survival of the sternal metastasis was 24 months.
  
  
  CONCLUSIONS
  Surgical resection and reconstruction of sternal lesions represent a basic step in the treatment of the primary tumors with encouraging survival results while in the metastatic lesions surgery can be a part of a multimodality approach with unsatisfactory results.
authors.affiliation: Department of Thoracic and Vascular Surgery, University of Parma, Parma, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Carbognani
authors.forename: A
authors.initials: A
authors.lastname: Vagliasindi
authors.forename: P
authors.initials: P
authors.lastname: Costa
authors.forename: L
authors.initials: L
authors.lastname: Pascarella
authors.forename: L
authors.initials: L
authors.lastname: Pazzini
authors.forename: A
authors.initials: A
authors.lastname: Bobbio
authors.forename: M
authors.initials: M
authors.lastname: Rusca
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D016025:Bone Transplantation; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002813:Chondrosarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D013249:Sternum / Q000473:pathology / Q000601:surgery*; D013526:Surgical Mesh; D015996:Survival Rate; D013899:Thoracic Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery