[Chest wall and vertebral en-bloc resection for sarcoma: ten-year experience].
OBJECTIVE
We reviewed our ten-year experience with surgical en-bloc chest wall and vertebral resection for sarcoma invading the spine, and verified five-year survival and feasibility of this aggressive surgery.


METHODS
From 1994 to 1999, 13 patients underwent surgical en-bloc resection for primary sarcoma of the chest wall involving the spine. Concurrent pulmonary resection was performed in 12 cases. A single hemi-vertebrectomy was performed in 2 patients, a triple hemi-vertebrectomy in 2, a complete vertebrectomy in 4, a triple complete vertebrectomy in 5.


RESULTS
Significative morbidity occurred in 1 patient who had lower limbs paralysis (9%). Perioperative mortality occurred in 2 patients (15.4%): 1 operative death for bleeding and 1 patients for a adult respiratory distress syndrome (ARDS). The overall five-year survival was 30.8%, excluding the 2 perioperative deaths the five-year survival resulted 36.4%.


CONCLUSIONS
In spite of the limited number of patients, the morbidity and mortality outcome and the five-year survival leads us to think that surgery is the main therapy for primary chest wall sarcomas involving the spine. En-bloc chest wall and vertebral resection is a safe and effective treatment.
Incarbone
M
M
Unità Operativa di Chirurgia Toracica e Generale, Istituto Clinico Humanitas, Rozzano, Milan. matteo.incarbone@humanitas.it
Alloisio
M
M
Luzzati
S
S
Testori
A
A
Cariboni
U
U
Infante
M
M
Errico
V
V
Canevini
M
M
Ravasi
G
G
D005240:Feasibility Studies; D006801:Humans; D012509:Sarcoma / Q000401:mortality / Q000601:surgery*; D013125:Spinal Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D013899:Thoracic Neoplasms / Q000401:mortality / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*; D035441:Thoracic Wall / Q000601:surgery*; D013997:Time Factors