Document Detail


Radical resection of radiation-induced sarcoma of the chest wall: report of 15 cases.
MedLine Citation:
PMID:  8993268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Surgical management of radiation-induced sarcoma of the chest wall remains difficult because of its impressive local aggressiveness. METHODS: Between 1987 and 1995, 15 patients (median age, 58 years) underwent radical resection of radiation-induced sarcoma of the chest wall. This type of tumor was defined as a metachronous, histologically different neoplasm in the irradiated field of the original tumor. Ten patients had a history of primary breast cancer and 5 patients, Hodgkin's disease. The median delivered radiation dose to the primary tumor area was 45 Gy, and the median interval between radiotherapy and diagnosis of sarcoma was 14 years. Seven tumors were located on the sternum, three on the lateral chest wall, and five in the thoracic outlet. Four total and three partial sternectomies, three lateral chest wall resections and five resections of tumors in the thoracic outlet (three first-rib resections) were performed. Seven patients required stabilization of the chest wall with prosthetic material. Soft tissue reconstruction was carried out with either muscle flaps and skin advancement in 9, musculocutaneous flaps in 4, or skin flaps alone in 2 patients. RESULTS: One patient died 3 months after total sternectomy of respiratory failure. Two patients (13.3%) had a local complication: sepsis after sternectomy in 1 and cutaneous necrosis in 1. Local recurrence occurred in 7 patients after a median interval of 10 months. Two of them died, and 4 underwent a repeat resection, 3 of whom are still alive. Four patients died of systemic recurrence. With a median follow-up of 30 months, overall 5-year survival and 5-year disease-free survival rates were 48% and 27%, respectively. CONCLUSION: Despite poor long-term disease-free survival, radical resection of radiation-induced sarcoma of the chest wall is justified on the basis of low postoperative morbidity and the lack of other available therapies.
Authors:
A R Chapelier; E A Bacha; V T de Montpreville; E M Dulmet; M Rietjens; A Margulis; P Macchiarini; P G Dartevelle
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  63     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-02-04     Completed Date:  1997-02-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  214-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Vascular Surgery, Hôpital Marie-Lannelongue, Paris-Sud University, Le Plessis-Robinson, France.
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MeSH Terms
Descriptor/Qualifier:
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Recurrence, Local / surgery
Neoplasms, Radiation-Induced / mortality,  surgery*
Neoplasms, Second Primary / mortality,  surgery*
Radiotherapy Dosage
Reoperation
Survival Rate
Thoracic Neoplasms / etiology*,  mortality,  surgery*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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