Objective : To evaluate survival results after extensive chest wall resections.
Methods : Retrospectively, 39 patients (19-77 y.o.) underwent 55 procedures. Tumor etiology was chest wall sarcoma in 8 patients, non-small cell lung carcinoma (NSCLC) invading the chest wall in 5 patients, mediastinal tumors in 10 patients, metastatic sarcoma or carcinoma in 13 patients. Three patients presented with extensive radiodermitis.
Fourteen patients (36%) underwent simple resections whereas 25 patients (64%) had resections extended to any of the intrathoracic or mediastinal structures.
The average number of resected ribs was 3,7 (1-6), 7 sternectomies were performed. Resection was complete in 29 patients (80%), and incomplete in 7 patients (20%). Primary and complex reconstruction (prosthetic and/or autologous material) was performed in 5 and 34 patients respectively.
Results : In-hospital mortality was 2,6% (one patient) and morbidity 16%. Mean follow-up was 30 months. All patients were included in the data analysis. Median survival was 16,6 months (0,7-162 months). The actuarial survival at 3 years were 85% for primary parietal tumors, 66% for NSCLC with parietal invasion, 82% for mediastinal tumors and 50% for parietal metastasis. More than 60% of the survivors returned to their previous activities with minor adjustment .
Conclusion : Extensive parietal resections with complex reconstruction offer a reliable solution to the esthetic, functional, vital problems with acceptable mortality and morbidity. In this study, the good long-term survival seems to be correlated to the completeness of the resection.