Surgical treatment of primary soft tissue sarcomas involving the chest: experiences in 25 patients.
BACKGROUND
Primary soft tissue sarcomas of the chest wall are uncommon and data concerning treatment and results are sparse. We reviewed our experience with chest wall resections of these lesions.


METHODS
Retrospective review of our database identified 25 patients (12 men, 13 women) who underwent chest wall resection for primary soft tissue sarcoma during the 18-year study period (January 1984 through to January 2002). The mean follow-up period was 46.5 months.


RESULTS
The 30-day mortality was zero. The cumulative 5-year survival rate of all 25 patients was 56.9 %, and the median survival 99.5 months. This compared with 42.2 % and a median survival of 36.0 months after chest wall resection for high grade tumor histology. Histological type grading clearly influenced long-term survival ( P = 0.036). Local recurrence occurred in 9 patients, 6 of 8 who were resected with positive margins and 3 of 17 who were resected with negative margins. Chest wall resections extended with lung resections did not significantly impair postoperative pulmonary function compared to patients without concomitant lung resections.


CONCLUSIONS
Chest wall resections in primary soft tissue sarcomas can be accomplished safely with a low mortality rate. Long-term survival can be achieved for primary soft tissue sarcomas but histological grading is of prognostic significance.
Pfannschmidt
J
J
Department of Thoracic Surgery, Thoraxklinik Heidelberg, University of Heidelberg, Heidelberg, Germany. joachim.pfannschmidt@thoraxklinik-heidelberg.de
Geisbüsch
P
P
Muley
T
T
Dienemann
H
H
Hoffmann
H
H
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D012189:Retrospective Studies; D012272:Ribs / Q000601:surgery; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013147:Spirometry; D013249:Sternum / Q000601:surgery; D013524:Surgical Flaps; D016019:Survival Analysis; D013899:Thoracic Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019616:Thoracic Surgical Procedures / Q000009:adverse effects; D035441:Thoracic Wall / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D047368:Tumor Burden; D014797:Vital Capacity