“Oncological Resection and Reconstruction of the Chest Wall –19 year experience in a single center”

OBJECTIVE: The study aim was to analyse chest wall reconstruction following oncological resection by a single surgeon over an 19 year period. METHODS: A retrospective review was performed for 135 patients who underwent oncological chest wall resection during 1997-2015. RESULTS: Average patient age was 57.8 years. Indications for resection were: advanced breast cancer n=44, soft tissue sarcoma n=38, bone or chondrosarcoma n=28, desmoid tumour n=11, metastasis from other cancers n=7, and other primary tumours n=7. There were 72 full-thickness and 63 partial-thickness resections (34 soft tissue resections only and 29 skeletal bone resections only). Resection margins were wide n=29, marginal n=82 and intralesional n=24. Reconstruction was warranted in 118 cases: chest wall stabilization and flap coverage n=57, chest wall stabilization only n=36 and soft tissue flap coverage only n=25. In total, 82 flaps were performed (17 free flaps and 65 pedicled/local flaps). There were no perioperative mortalities nor flap losses. Complications occurred in 29 operations (Clavien-Dindo classifications grII 12, grIIIa 4, grIIIb 10, grIVa 3) and 19 re-operations were necessary. Median follow-up was 49 months. Survival was calculated by the Kaplan and Meier Method. One- year, 2-year and 5-year survival rates were 84%, 82% and 70%, respectively. CONCLUSION: With careful patient selection, appropriate peri- and postoperative care and accurate surgical technique, even extensive chest wall resections and reconstructions are safe. Financial Disclosure Statement: Dr. Salo and Dr. Tukiainen had nothing to disclose. No funding was received for this article. Presented at (if applicable): EURAPS 2017 meeting, in Pisa, Italy Corresponding author: Juho T.K. Salo M.D., Department of Plastic Surgery, Töölö Hospital, PO Box 266, FIN 0029 HUS, Finland, email: juho.salo@hus.fi tel: + 358 50 428 4681 fax: + 358 9 471 87 217 ©2018American Society of Plastic Surgeons

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