title: Primary malignant chest wall tumors: analysis of 40 patients.
abstract: BACKGROUND
  Primary chest wall tumors originate from different constructions of thoracic wall. We report our multidisciplinary experience on primary thoracic tumor resection and thoracic reconstruction, the need to additional therapy and evaluating prognostic factors affecting survival.
  
  
  METHODS
  We performed a retrospective review of our prospectively maintained database of 40 patients treated for malignant primary chest wall tumor from 1989 to 2009. Patients were evaluated in terms of age, sex, clinical presentation, type of imaging, tissue diagnosis methods, pathology, surgical technique, early complications, hospital mortality, prevalence of recurrence and distant metastases, additional treatment, 3 years survival and factors affecting survival.
  
  
  RESULTS
  Male/Female (F/M) = 1, with median age of 43.72 years. Mass was the most common symptoms and the soft tissue sarcoma was the most common pathology. Resection without reconstruction was performed in 5 patients and Thirty-five patients (87.5%) had extensive resection and reconstruction with rotatory muscular flap, prosthetic mesh and/or cement. Overall, 12.5% (5/40) of patients received neoadjuvant therapy and 75% (30/40) of patients were treated with adjuvant therapy. The 3-year survival rate was 65%. Recurrences occurred in 24 patients (60%), 14 developed local recurrences, and 10 developed distant metastases. The primary treatment modality for both local and distant recurrences was surgical resection; among them, 10 underwent repeated resection, 9 adjuvant therapy and 5 were treated with lung metastasectomy. The most common site of distant metastasis was lung (n = 7). Factors that affected survival were type of pathology and evidence of distant metastasis.
  
  
  CONCLUSIONS
  Surgery with wide margin is the safe and good technique for treatment of primary chest wall tumors with acceptable morbidity and mortality.
authors.forename: Reza
authors.initials: R
authors.lastname: Bagheri
authors.forename: Seyed Ziaollah
authors.initials: SZ
authors.lastname: Haghi
authors.forename: Mahmoud Reza
authors.initials: MR
authors.lastname: Kalantari
authors.affiliation: Endoscopic & Minimally Invasive Surgery Research Center, Department of Anesthesiology, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Emis@mums.ac.ir.
authors.forename: Alireza
authors.initials: A
authors.lastname: Sharifian Attar
authors.forename: Maryam
authors.initials: M
authors.lastname: Salehi
authors.forename: Azadeh
authors.initials: A
authors.lastname: Tabari
authors.forename: Maliheh
authors.initials: M
authors.lastname: Soudaneh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002648:Child; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate / Q000639:trends; D013899:Thoracic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D035441:Thoracic Wall; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult