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胸壁肉瘤手术切除相关的临床结果和并发症

Clinical outcomes and complications associated with surgical resection of chest wall sarcoma.

作者信息

Ishihara Shin, Yotsukura Masaya, Watanabe Shun-Ichi, Arikawa Masaki, Akazawa Satoshi, Fukushima Suguru, Osaki Shuhei, Ogura Koichi, Iwata Shintaro, Kawai Akira, Kobayashi Eisuke

机构信息

Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, 104-0045, Japan.

Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, 104-0045, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2025 Sep 2. doi: 10.1007/s11748-025-02191-6.

Abstract

INTRODUCTION

Chest wall sarcomas are rare malignant mesenchymal tumors arising from soft tissue, cartilage and bones. Wide resection is usually the treatment option but often results in postoperative complications after resection of the chest wall. In this study, we reviewed cases of chest wall sarcoma treated with resection of the sternum or ribs and examined the factors that could cause complications.

MATERIALS AND METHODS

We enrolled consecutive patients with sarcoma who underwent chest wall surgery with resection of the sternum or ribs between January 2007 and October 2022. We collected data on age, sex, tumor location and size, histology, and detailed resection data of the lung, diaphragm, ribs, sternum, and postoperative complications.

RESULTS

Seventy-one patients were included in the study. The 5-year overall survival and disease-free survival rates were 76.8% and 56.8%, respectively. Age ≤ 63 years was associated with poor disease-free survival (p = 0.019) in the multivariate analysis. Nineteen patients (26.7%) had postoperative complications such as surgical site infections and respiratory disorders. None of the patients died after surgery. Resection of 4 or more ribs was positively correlated with the occurrence of complications (p = 0.040), with an occurrence rate of 45%.

CONCLUSION

The current study is one of the largest to focus on postoperative complications associated with surgery for chest wall sarcoma with resection of the ribs or sternum. This study suggests that careful postoperative management is advisable when 4 or more ribs are resected during surgery for chest wall sarcoma.

摘要

引言

胸壁肉瘤是起源于软组织、软骨和骨骼的罕见恶性间叶组织肿瘤。广泛切除通常是治疗选择,但切除胸壁后常导致术后并发症。在本研究中,我们回顾了接受胸骨或肋骨切除治疗的胸壁肉瘤病例,并研究了可能导致并发症的因素。

材料与方法

我们纳入了2007年1月至2022年10月期间连续接受胸骨或肋骨切除的胸壁手术的肉瘤患者。我们收集了患者的年龄、性别、肿瘤位置和大小、组织学以及肺、膈肌、肋骨、胸骨的详细切除数据和术后并发症数据。

结果

71例患者纳入本研究。5年总生存率和无病生存率分别为76.8%和56.8%。多因素分析显示,年龄≤63岁与无病生存率低相关(p = 0.019)。19例患者(26.7%)出现术后并发症,如手术部位感染和呼吸功能障碍。术后无患者死亡。切除4根或更多肋骨与并发症的发生呈正相关(p = 0.040),发生率为45%。

结论

本研究是关注肋骨或胸骨切除治疗胸壁肉瘤术后并发症的最大规模研究之一。本研究表明,胸壁肉瘤手术切除4根或更多肋骨时,术后应进行仔细管理。

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