419P - Surgical treatment of malignant tumours and metastatic lesions of the chest wall

Background

Tumors of the chest wall are relatively rare. Malignant tumors of the chest wall make up 4% of the structure of cancer and 1-2% of all primary tumors. Malignant tumors of the ribs and sternum made up 13% of the number of patients with bone tumors. The main treatment for chest wall tumors is surgical treatment. Unlike primary, metastatic bone tumors occur 2-4 times more often.

Methods

From 2010 to 2019, in KazIOR provide operations for 78 patients with chest wall tumors, in which 60(76.9%) malignant bone tumors (chondrosarcoma 26(33.3%) and osteogenic sarcoma 34(43.6%), 2(2.6%) metastatic bone lesions, 16(20.5%) soft tissue tumors. The average age was 46.4years, the ratio of men and women 1: 1. 16(20.5%) patients underwent resection of the sternum (manubrium 2(2.6%), body 5(6.4%), xiphoid process 3(3.9%), middle third of the sternum 2(2.6%), the sternum and clavicle 2(2.6%), the xiphoid process of the sternum+costal arch of both sides+diaphragm and peritoneum in 1(1.2%) patient, middle third of the sternum+clavicle+3 ribs 1(1.2%)) and 62(79.5%) resection of the ribs (1 rib 14(17.9%), 2 ribs 12(15.5%), 3 ribs 3(3.9%), 4 ribs 3(3.9%), 5 ribs 1(1.2%), costal arch 1(1.2%), 28(35.9%) patients combined resection of ribs with nearby bones of the chest wall, various structures of the mediastinum and visceral organs.

Results

After resection of 3 ribs or more along the anterolateral surface and total or subtotal resection of the sternum 39(50%) patients underwent reconstructive plastic surgery. In 25(32%) cases used prolene mesh, in 2(2.6%) a displaced skin-fat flap, in 2(2.6%) a thoracodorsal flap (TDL), in 2(2.6%) a greater omentum and in 8(10.2%) combined plasty (prolene mesh+rectoabdominal flap in 2(2.6%) patients, prolene mesh+displaced pectoral flap in 4(5.1%), prolene mesh+TDL in 1(1.2%), prolene mesh + skin-fatty flap in 1(1.2%).

Conclusions

Due to the radical removal of the tumor in combination with the reconstruction of postoperative extensive defects of the chest wall, the quality of life of patients is improved and good functional results are achieved - ease of construction and at the same time the required rigidity of the frame. Despite a significant amount of experimental work research in this area is ongoing.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Kazakh Reserch Institute of Oncology & Radiology (KazIOR).

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.