ArticleInterdisciplinary cardiovascular and thoracic surgery2025
Long-term outcome and prognostic factors after chest wall resection and reconstruction.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesOur study aimed to evaluate factors influencing perioperative and long-term outcomes of patients undergoing curative-intent chest wall resection and reconstruction.
methodsA retrospective single-centre analysis was conducted on all patients undergoing curative-intent chest wall resection and reconstruction from 2010 to 2023. Perioperative outcome was analysed for the entire cohort. Overall survival and disease-free survival were analysed using the Kaplan-Meier method and log-rank test and multivariable Cox proportional hazards regression models with a particular focus on patients with lung cancer and chest wall involvement.
resultsA total of 143 consecutive patients (median age 62 years, 44.1% females) were included, and 75% of patients received perioperative systemic therapy or radiation. Rib resection alone was performed in 69.9%, additional sternal resection in 16.1%, spine resection in 11.9% and clavicle resection in 2.1%. Additional resections included the lung (n = 75), diaphragm (n = 6), pericardium (n = 2), subclavian vein (n = 2), pulmonary artery (n = 1) and multiple structures (n = 22). Reconstruction was performed using synthetic protheses (n = 89), metallic (n = 6) or combinations of materials (n = 32). Median tumour diameter was 10 cm; 88% were malignant. Local recurrence rate was 9.5%. Median disease-free survival (86 events) was 36 months, and median overall survival (62 events) was 80 months. The 5-year disease-free survival and overall survival were 54.1% and 74.1%, respectively. In patients with lung cancer, overall survival was significantly affected by age (P = 0.028), histology (P < 0.001), resection size >10 cm (P = 0.018), postoperative performance status (P < 0.001) and postoperative complications (P < 0.001) in multivariable analysis and disease-free survival by postoperative performance status (P < 0.001).
conclusionsPostoperative performance status is correlated with overall survival after chest wall resection.
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