title: Gold standard for sternectomies and plastic reconstructions after resections for primary or secondary sternal neoplasms.
abstract: BACKGROUND
  Between January 1980 and December 1999, 88 patients underwent the surgical resection of sternal tumors: 30 primary malignant tumors, 28 local relapses or metastases from breast carcinomas, 16 other types of tumor, and 14 radionecroses.
  
  
  METHODS
  The sternectomies were total in 8 cases, subtotal in 32, and partial in 48. Prosthetic materials covered by flaps of myocutaneous or muscle tissue were used in 55 patients, prosthetic material alone in 13, myocutaneous or muscle flaps alone in 5, and other techniques in the remaining 15. The resection was radical in 78 cases and palliative in the other 10.
  
  
  RESULTS
  Forty-eight of the subjects who underwent radical surgery were alive and disease free at the end of the follow-up period. The expected 10-year survival of the patients treated for primary tumors is approximately 85% (Kaplan-Meier), and that of the patients with relapsing breast carcinomas is the same as after 5 years (41.8%).
  
  
  CONCLUSIONS
  In our experience, the treatment of neoplasms by means of a broad sternal resection followed by a reconstruction based on the use of prosthetic materials is an effective and safe solution that considerably improves the quality of life and makes it possible to perform curative broad radical resections in the case of primary sternal resections.
authors.affiliation: Department of Oncologic Thoracic Surgery, Istituto Nazionale Tumori, Via Venezian 1, 20133 Milan, Italy. lequaglie@istitutotumori.mi.it
authors.forename: Cosimo
authors.initials: C
authors.lastname: Lequaglie
authors.forename: PierPaolo Brega
authors.initials: PB
authors.lastname: Massone
authors.forename: Gabriella
authors.initials: G
authors.lastname: Giudice
authors.forename: Barbara
authors.initials: B
authors.lastname: Conti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009381:Neoplasms, Radiation-Induced / Q000473:pathology / Q000601:surgery*; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013249:Sternum / Q000473:pathology* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome