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Single-Institution, Multidisciplinary Experience of Soft Tissue Sarcomas in the Chest Wall

Kuwahara, Hiroaki MD, PhD*†; Salo, Juho MD*; Nevala, Riikka MD, PhD; Tukiainen, Erkki MD, PhD*

doi: 10.1097/SAP.0000000000001901
Reconstructive Surgery

Introduction We report our single-institution, multidisciplinary experience of nearly 20 years of working on chest wall soft tissue sarcoma cases. The aim of this study was to evaluate clinical outcomes in patients with chest wall soft tissue sarcoma.

Materials and Methods A retrospective review of 49 surgically treated patients with chest wall soft tissue sarcoma was conducted from 1997 to 2015.

Results The median age of the patients was 57.0 years. There were 19 full-thickness and 30 partial-thickness resections. Reconstruction was warranted in 37 cases. Sarcomas were high grade in 31 (63.3%) and low grade in 18 (36.7%) cases. Local recurrence developed in 8 and metastasis in 9 patients. No 30-day mortality occurred. By the end of the study period, 35 patients were alive and 14 had died. The 1-, 5-, and 10-year survival rates were 93.8%, 76.0%, and 71.6%, whereas the overall recurrence-free rates were 84.4%, 70.7%, and 70.7% respectively. Favorable prognostic variables for survival included age <50 years and radical treatment (resection with wide margin or resection with marginal margin and adjuvant radiotherapy). Patients who had undergone nonradical treatment had a 3.1-fold lower chance of survival than did those who had undergone radical treatment (95% confidence interval, 0.96–10.12; P = 0.06).

Conclusions Our study suggests that surgical resection with wide margins should continue to be the mainstay for patients with chest wall sarcoma. Even extensive chest wall resections and reconstructions are safe. If wide margins are not achieved, (neo)adjuvant radiotherapy should be considered to improve local control.

From the *Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland;

Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan; and

Department of Oncology, Helsinki University Hospital, Finland.

Received September 3, 2018, and accepted for publication, after revision January 28, 2019.

H.K. and J.S. as co-first authors equally contributed to this work.

Conflicts of interest and sources of funding: none declared.

Reprints: Hiroaki Kuwahara, MD, PhD, Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugimachi, Kawasaki-si, Kanagawa 211-8533, Japan. E-mail:

Online date: April 4, 2019

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