Classification of the Volume of Tumor Lesion of the Chest Wall as A Prerequisite for Planning Surgical Treatment
https://doi.org/10.17650/2219-4614-2024-16-2-32-38
Abstract
Tumors of the chest wall are a heterogenous group of neoplasms per nosology, clinical progression, and treatment methods. Primary tumors of this location, according to some authors, comprise between 1 and 5 %, and 60 % of them are malignant. Tumors of the chest wall can have not only various nosological forms but also varying volume, location, affect different structures of the chest wall which are determined during physical exam. Despite the progress in drug therapy, radical surgical intervention is a prerequisite for successful treatment of patients with malignant tumors of the chest wall. One of the most important prognostic factors is sufficient margin during chest wall resection. The international tumor classification system Tumor, Nodus and Metastasis (TNM) does not give a complete understanding of the volume of lesions and therefore does not allow to correctly plan resection volume and defect reconstruction based on its data.
The article presents a classification of tumor volume of the chest wall proposed by the Sarcoma Research Association which allows to expand indications for surgical treatment and select the optimal type of defect reconstruction.
About the Authors
A. K. Valiev
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
A. G. Salkov
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
A. V. Fedorova
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
O. Efimenko
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
I. V. Eltsov
N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
24 Kashirskoe Shosse, Moscow 115522
References
1. Aliyev M.D., Bohyan A.Yu., Ivanov S.M. et al. Clinical recommendations for the diagnosis and treatment of patients with primary malignant bone tumors. (Treatment of primary patients only in specialized centers.) Moscow, 2014. Available at: https://oncology-association.ru/wp-content/uploads/2020/09/opukholi-kosti.pdf. (In Russ.).
2. Malignant neoplasms in Russia in 2018. Ed. by A.D. Kaprin, V.V. Starinsky, G.V. Petrova. Moscow: MNIOI im. P.A. Gertsena – filial FGBU “NMITS radiologii” Minzdrava Rossii, 2019. 250 p. (In Russ.).
3. Aranda J.L., Varela G., Benito P. Donor cryopreserved rib allografts for chest wall reconstruction. Interact CardioVasc Thorac Surg 2008;7(5): 858–60. DOI: 10.1510/icvts.2008.183905
4. Trapeznikov N.N., Tsurkan A.M. Savings and savings-recovery operations for bone tumors. Moscow, 1990. Pp. 108–129. (In Russ.).
5. Akhmedov B.P. Metastatic tumors. Moscow: Meditsina, 1984. 186 p. (In Russ.).
6. Davydov M.I., Aliyev M.D., Sobolevsky V.A., Ilyushin A.L. Surgical treatment of malignant tumors of the chest wall. Vestnik Rossijskogo onkologicheskogo nauchnogo tsentra = Bulletin of the Russian Cancer Research Center 2008;1:19. (In Russ.).
7. Demondion P., Mercier O., Kolb F., Fadel E. Sternal replacement with a custommade titanium plate after resection of a solitary breast cancer metastasis. Interact CardioVasc Thorac Surg 2014;18(1):145–7. DOI: 10.1093/icvts/ivt456
8. Aranda J.L., Jimenez M.F., Rodríguez M., Varela G. Tridimensional titanium-printed custom-made prosthesis for sternocostal reconstruction. Eur J Cardiothorac Surg 2015;48(4):e92–4. DOI: 10.1093/ejcts/ezv265
9. Turna A., Kavakli K., Sapmaz E. et al. Reconstruction with a patientspecific titanium implant after a wide anterior chest wall resection. Interact CardioVasc Thorac Surg 2014;18(2):234–6.
10. Simal I., García-Casillas M., Cerdá J. et al. Three-dimensional custommade titanium ribs for reconstruction of a large chest wall defect. European J Ped Surg Rep 2016;4(1):26–30. DOI: 10.1055/s-0036-1593738
11. Wang L., Cao T., Li X., Huang L. Three-dimensional printing titanium ribs for complex reconstruction after extensive posterolateral chest wall resection in lung cancer. J Thorac Cardiovasc Surg 2016;152(1):e5–7. DOI: 10.1016/j.jtcvs.2016.02.064
12. Anderson C.J., Spruiell M.D., Wylie E.F. et al. A technique for pediatric chest wall reconstruction using custom-designed titanium implants: description of technique and report of two cases. J Child Orthop 2016;10(1):49–55. DOI: 10.1007/s11832-015-0709-1
13. Kang J., Wang L., Yang C. et al. Custom design and biomechanical analysis of 3D-printed PEEK rib prostheses. Biomech Model Mechanobiol 2018;17(4):1083–92. DOI: 10.1007/s10237-018-1015-x
14. Aragon J., Perez Mendez I. Dynamic 3D printed titanium copy prosthesis: a novel design for large chest wall resection and reconstruction. J Thorac Dis 2016;8(6):e385.9. DOI: 10.21037/jtd.2016.03.94
15. Moradiellos J., Amor S., Córdoba M. et al. Functional chest wall reconstruction with a biomechanical three-dimensionally printed implant. Ann Thorac Surg 2017;103(4):e389–91. DOI: 10.1016/j.athoracsur.2016.11.048
16. Wang L., Huang L., Li X. et al. Three-dimensional printing PEEK implant: a novel choice for the reconstruction of chest wall defect. Ann Thorac Surg 2019;107(3):921–8. DOI: 10.1016/j.athoracsur.2018.09.044
17. Minh D., Tran M.D., Jason A. et al. Novel sternal reconstruction with custom. Three-dimensional-printed titanium porestar prosthesis. Innovations (Phila) 2018;;13(4):309–11. DOI: 10.1097/IMI.0000000000000511
18. Salkov A.G., Valiev A.K., Kharatishvili T.K. et al. The first experience of successful total extirpation of the sternum with the replacement of the defect with an individual 3D implant and a synthetic plate. A clinical case. Sarkomy kostei, miagkikh tkanei i opukholi kozhi = Bone and Soft Tissue Sarcomas, Tumors of the Skin 2020;1:62–7. (In Russ.).
19. Cormack P., Bains M., Beattie E.J. New trends in skeletal reconstruction after resection of chest wall at a large institution. J Thorac Cardiovasc Surg 1981;31(1):45–52. DOI: 10.1016/s0003-4975(10)61315-x
20. Zatsepin S.T. Bone pathology of adults. Moscow: Meditsina, 2001. Pp. 501–519. (In Russ.).
21. Arnold P.G., Pairolero P.C. Chest wall reconstructions: an account of 500 consecutive cases. Plast Reconstr Surg 1996;98(5):804–10. DOI: 10.1097/00006534-199610000-00008.
22. Abbas A.E., Deschamps C., Cassivi S. Chest-wall desmoid tumors: results of surgical intervention. Ann Thorac Surg 2004;78(4):1219–23. DOI: 10.1016/j.athoracsur.2004.03.015
23. Cipriano A., Burfeind W., Jr. Management of primary soft tissue tumors of the chest wall. Thorac Surg Clin 2017;27(2):139–47. DOI: 10.1016/j.thorsurg.2017.01.007
24. D’ddario G., Früh M., Reck M. et al. Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatmentand follow-up. Ann Oncol 2010;21(Suppl. 5):v116–9. DOI: 10.1093/annonc/mdq189
25. David E.A., Marshall M.B. Review of chest wall tumors: a diagnostic, therapeutic, and reconstructive challenge. Semin Plast Surg 2011;25(1):16–24. DOI: 10.1055/s-0031-1275167
26. Shah A.C., Komperda K.W., Mavanur A.A. et al. Overall survival and tumor recurrence after surgical resection for primary malignant chest wall tumors: a single-center, single-surgeon experience. J Orthop Surg 2019;27(2):230949901983829. DOI: 10.1177/2309499019838296
27. Wang L., Yan X., Zhao J. et al. Expert consensus on resection of chest wall tumors and chest wall reconstruction. Transl Lung Cancer Res 2021;10(11):4057–83. DOI: 10.21037/tlcr-21-935
28. Widhe B., Bauer H.C.F. Surgical treatment is decisive for outcome in chondrosarcoma of the chest wall: a population-based Scandinavian Sarcoma Group study of 106 patients. J Thorac Cardiovasc Surg 2009;137(3):610–4. DOI: 10.1016/j.jtcvs.2008.07.024
29. Chapelier A.R., Missana M.C., Couturaud B. et al. Sternal resection and reconstruction for primary malignant tumors. Ann Thorac Surg 2004;77(3):1001–7. DOI: 10.1016/j.athoracsur.2003.08.053
30. Davydov M.I., Aliyev M.D., Polotsky B.E. et al. Treatment of locally common tumors of the chest wall. Cases from practice. Vestnik onkologii = Bulletin of Oncology 2003;2:93–6. (In Russ.).
31. Arrabal Sanchez R. Primary tumors of the thoracic wall (1991–1994). Arch Bronconeumol 1996;32(8):384–7.
32. King R.M., Pairolero P.C., Trastek V.F. et al. Primary chest wall tumors: factors affecting survival. Ann Thorac Surg 1986;41(6):597–601. DOI: 10.1016/s0003-4975(10)63067-6
33. Walsh G.L., Davis B.M., Swisher S.G. et al. A single-institutional, multidisciplinary approach to primary sarcomas involving the chest wall requiring full-thickness resections. J Thorac Cardiovasc Surg 2001;121(1):48–60. DOI: 10.1067/mtc.2001.111381
34. Weyant M.J., Bains M.S., Venkatraman E. et al. Results of chest wall resection and reconstruction with and without rigid prosthesis. Ann Thorac Surg 2006;81(1):279–85. DOI: 10.1016/j.athoracsur.2005.07.001
35. Zhang Y., Li J.Z., Hao Y.J. et al. Sternal tumor resection and reconstruction with titanium mesh: a preliminary study. Orthop Surg 2015;7(2): 155–60. DOI: 10.1111/os.12169
36. Pontiki A.A., Natarajan S., Parker F.N.H. et al. Chest wall reconstruction using 3-dimensional printing: functional and mechanical results. Ann Thorac Surg 2022;114(3):979–88. DOI: 10.1016/j.athoracsur.2021.07.103
37. Harati K., Kolbenschlag J., Behr B. et al. Thoracic wall reconstruction after tumor resection. Front Oncol 2015;5:247. DOI: 10.3389/fonc.2015.00247
38. Wang L.W., Li L., Zhang H.Y. et al. Patterns of chest wall recurrence and suggestions on the clinical target volume of breast cancer: a retrospective analysis of 121 postmastectomy patients. Cancer Manag Res 2020;12:5909–18. DOI: 10.2147/CMAR.S250789
39. Leonardi B., Carlucci A., Noro A. et al. Three-dimensional printed models for preoperative planning and surgical treatment of chest wall disease: a systematic review. Technologies 2021;9(4):97. DOI: 10.3390/technologies9040097
40. Ninomiya H., Miyoshi T., Shirakusa T. et al. Postradiation sarcoma of the chest wall: report of two cases. Surg Today 2006;36(12):1101–4. DOI: 10.1007/s00595-004-3300-9
41. Mayer R., Aigner C., Stranzl H. et al. Radiation-induced osteosarcoma of the chest wall. Breast J 2002;8(5):320–2. DOI: 10.1046/j.1524-4741.2002.08517.x
Review
For citations:
Valiev A.K., Salkov A.G., Fedorova A.V., Efimenko O., Eltsov I.V. Classification of the Volume of Tumor Lesion of the Chest Wall as A Prerequisite for Planning Surgical Treatment. Bone and soft tissue sarcomas, tumors of the skin. 2024;16(2):32-38. (In Russ.) https://doi.org/10.17650/2219-4614-2024-16-2-32-38
Views:
343
Email this article 
