The Role of Surgery in Primary Chest Wall Tumors: Over 20 Years’ Experience in Resection and Reconstruction

Primary chest wall tumors comprise a group of rare tumors for which the best treatment method has yet to be determined. As surgeons, we wanted to explore our role in approaching these pathologies to analyze the role of surgery amidst other oncological considerations. It is clear that radical oncological surgery is an essential element of a multidisciplinary approach. Background: Primary chest wall tumors comprise a heterogeneous group of neoplasms arising from soft tissues and bones. While surgical excision is the standard of care for benign tumors, the management of malignant tumors requires multimodal treatment. We conducted a predictive analysis of outcome, recurrence-free and overall survival. Methods: We retrospectively reviewed the clinical and pathological records of all patients treated in our center between 1998 and 2020. Results: 53 patients (15-85 years) were treated in our department. The average tumor diameter was 65 +/- 35 mm (10-160 mm). Negative margins were obtained in 48 patients (90.6%), whereas in the remaining 5, R1 resection was accomplished. Median overall survival was 63,03 months (1-282 months). Overall survival was 90% at 1 year, 78% at 2 years, and 61% at 5 years. Our analysis identified tumor diameter, postoperative complications, and high grade of malignancy as factors that can influence prognosis. Conclusions: The treatment of primary chest wall tumors remains a very challenging process. Different histological types preclude definition of an unequivocal approach. Complete resection with healthy margins remains a definitive cornerstone in the treatment of these cancers as part of a more comprehensive approach.