ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Oncological results in primary and secondary malignant chest wall tumors
Gökhan Kocaman1, Yusuf Kahya1, Buse Mine Konuk Balcı1, Bülent Mustafa Yenigün1, Murat Özkan1, Hilal Özakıncı2, Duru Karasoy3, Cabir Yüksel1, Serkan Enön1, Ayten Kayı Cangır1
1Department of Thoracic Surgery, Medicine Faculty of Ankara University, Ankara, Türkiye
2Department of Pathology, Moffit Cancer Center, Florida, USA
3Department of Statistics, Medicine Faculty of Hacettepe University, Ankara, Türkiye
DOI : 10.5606/tgkdc.dergisi.2024.25393
Background: This study aims to evaluate the oncological results of primary and secondary chest wall tumors treated with curative resections and to investigate possible prognostic factors.

Methods: Between January 2010 and December 2021, a total of 77 patients (53 males, 24 females; median age: 59 years; range, 3 to 87 years) who underwent curative resection for malignant chest wall tumors were retrospectively analyzed. Each tumor was staged according to its histological type. Age, sex, tumor diameter, tumor type (primary/secondary), histological tumor type, grade, stage, complete resection, rib resection, reconstruction, neoadjuvant and adjuvant therapy, recurrence, and survival data were recorded.

Results: Of the chest wall tumors, 33 (42.9%) were primary and 44 (57.1%) were secondary (local invasion, metastasis). Nine (11.7%) patients had positive surgical margins. Chest wall resection was most commonly performed due to lung cancer invasion (46.8%), followed by Ewing sarcoma (13%). Recurrence was observed in 34 (44.2%) patients. The five-year recurrence-free survival rate was 42.7% and the five-year overall survival rate was 58.6%. There was no significant difference between the primary and secondary tumors in terms of recurrence-free and overall survival (p=0.663 and p=0.313, respectively). In the multivariate analysis, tumor grade and rib resection were found to be independent prognostic factors for both recurrence-free survival (p=0.005 and p<0.001, respectively) and overall survival (p=0.048 and p=0.007, respectively).

Conclusion: Successful oncological results can be achieved in wellselected patients with primary and secondary chest wall tumors. The grade of the tumor should be taken into account while determining the neoadjuvant or adjuvant treatment approach and surgical margin width. Rib resection should not be avoided when necessary.

Keywords : Malignant chest wall tumor, primary chest wall tumor, secondary chest wall tumor
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