Soft Tissue Sarcomas of the Chest Wall

Introduction: Soft tissue sarcomas originating from the chest wall include in their definition those originating from the trunk and, in many cases, are analyzed together with retroperitoneal tumors whose clinical results differ, with only a few detailed reports on such tumors strictly limited to the chest wall available. The main purpose of this study was to evaluate the clinical outcomes for patients with chest wall soft tissue sarcomas. Methods: A retrospective review of 44 surgically treated patients was conducted from 1992 to 2006. The median age of the patients was 51.8 years. The median follow-tip time was 56.7 months. Twenty-two sarcomas (50.0%) were high-grade, and 22 (50.0%) were low-grade. Of the 44 patients, 31 (70.1%) had previously undergone unplanned excision elsewhere. Histologic examinations of the surgical margins, and oncological outcome for each patient were collected and analyzed. Results: Twenty-six (59.1%) patients were continuously free of disease, 12 were alive and currently free of disease, three were alive with metastasis, and three had died. Local recurrence developed in five patients. The overall survival rate at 5 years was 88.5%. Local recurrence-free survival rate at 5 years was 88.5%. Univariate analyses disclosed age (p < 0.05), high-grade malignancy (p < 0.05), and local recurrence (p < 0.05) as independent predictors of death. Histopathologic examination of the specimens showed that two patients had evidence of bone invasion. Conclusions: The clinical behavior of the chest wall soft tissue sarcomas is similar to that of extremity sarcomas. High-grade tumors are more likely to require a muscle transfer, and it is often very difficult to achieve local control of them in view of their anatomic characteristics. Considering the high local control rate in this study, they are best controlled by adequate wide surgical resection.