Chest wall tumors and prosthetic reconstruction: A comparative analysis on functional outcome. Issue 3 (May 2015)

• Record Type: Journal Article
• Authors: Leuzzi, Giovanni; Nachira, Dania; Cesario, Alfredo; Novellis, Pierluigi; Petracca Ciavarella, Leonardo; Lococo, Filippo; Facciolo, Francesco; Granone, Pierluigi; Margaritora, Stefano
• Is Part Of: Thoracic cancer. Volume 6:Issue 3(2015)
• Page Start: 247
• Page End: 254
• Publication Date: 2015-05
• Subjects: Chest wall tumor -- FEV1 -- prosthesis -- PTFE; Chest -- Cancer -- Periodicals; Chest -- Cancer -- Treatment -- Periodicals; Chest -- Surgery -- Periodicals; 616.99494005
• DOI: 10.1111/1759-7714.12172
• Languages: English
• ISSNs: 1759-7706

Abstract

Abstract: Background: To address the question of how much chest‐wall (CW) resections and prosthetic reconstructions influence functional outcome. Methods: We retrospectively reviewed 175 patients who underwent surgery for CW tumors. The clinical, histological, surgical, oncological, and functional factors were analyzed. Results: We performed: 75 rib resections; 20 sternal resections; 15 combined resections; and 27 lung resections. In 39 cases (22.2%) CW was stabilized with non‐rigid prosthesis (Vicryl‐mesh: 8 patients; Goretex‐mesh: 31 patients). Postoperative complications occurred in 22 cases (12.6%): a correlation with lung resection was evidenced by multivariate analysis ( P = 0.025). Five‐year survival for primary and secondary tumors was 50% and 36%, respectively: multivariate analysis ( P = 0.048) showed a worse survival in men only. In the prosthesis subset, pulmonary function tested as percentage of forced expiratory volume in one second (%FEV1) (pre: 87.1 ± 18.9%; post: 82.3 ± 23.0%, P = ns), percentage of forced vital capacity (pre: 94.1 ± 19.3%; post: 82.0 ± 21.6%, P = ns), diffusing capacity of the lungs for carbon monoxide (pre: 15.7 ± 7.4; post: 12.1 ± 4.1, P = ns) and paO2 (pre: 82.6 ± 10.9 mmHg; post: 83.9 ± 7.3 mmHg, P = ns) was slightly modified from pre to postoperative. Interestingly, the decline of FEV1% was lower in the prosthesis‐subset (4.1 ± 15.9%) compared with the subgroup who did not undergo prosthetic stabilization (17.5 ± 16.2%), but this difference was not statistically significant ( P = ns). Conclusion: Because of the low decrease of lung parameters, CW prosthetic reconstruction could be helpful for avoiding postoperative worsening of functional outcome, mostly in patients with pre‐existing pulmonary diseases.