Cipriano Anthony, Burfeind William
Department of Surgery, St. Luke's University Health Network, Bethlehem, PA 18015, USA.
Department of Surgery, St. Luke's University Health Network, Bethlehem, PA 18015, USA.
Thorac Surg Clin. 2017 May;27(2):139-147. doi: 10.1016/j.thorsurg.2017.01.007.
Primary chest wall tumors are rare and represent a challenging clinical entity. Preoperative work-up includes a thorough history, radiographic imaging, and a biopsy approach that does not make a future definitive resection more difficult. Treatment decisions are based on tumor histology, stage, local aggressiveness, and responsiveness to chemotherapy and radiation. Wide excision is the foundation of treatment of most malignant primary chest wall tumors. The role of radiation therapy in the neoadjuvant or adjuvant setting is to reduce local recurrence. The use of adjuvant chemotherapy is more controversial. For most primary chest wall malignancies, margin-negative resection remains the best chance of cure.
原发性胸壁肿瘤较为罕见,是一个具有挑战性的临床实体。术前检查包括详尽的病史、影像学检查以及活检方法,且活检方法不能使未来的根治性切除变得更加困难。治疗决策基于肿瘤组织学、分期、局部侵袭性以及对化疗和放疗的反应。广泛切除是大多数原发性恶性胸壁肿瘤治疗的基础。放疗在新辅助或辅助治疗中的作用是降低局部复发率。辅助化疗的应用更具争议性。对于大多数原发性胸壁恶性肿瘤,切缘阴性的切除仍然是治愈的最佳机会。