Gold standard for sternectomies and plastic reconstructions after resections for primary or secondary sternal neoplasms.
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.
Lequaglie
Cosimo
C
Department of Oncologic Thoracic Surgery, Istituto Nazionale Tumori, Via Venezian 1, 20133 Milan, Italy. lequaglie@istitutotumori.mi.it
Massone
PierPaolo Brega
PB
Giudice
Gabriella
G
Conti
Barbara
B
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