Analysis of Surgical Resection and Prognostic Factors of Primary Chest Wall Chondrosarcomas

ABSTRACT

Introduction: Primary chest wall tumours are very rare.Chondrosarcoma represents 40% of all chest wall tumours.Wide local excision with tumour free margins has been thegold standard therapy. We evaluated this therapy in relationto various prognostic factors for anticipating the recurrenceof the tumour.Material and methods: 22 cases of Primary chest wallchondrosarcoma was operated upon from 2009 to 2019 withwide local excision with adequate margins. Male constituted77.27% and females 22.73% with the tumour size rangingfrom 5 to 30 cm in size(median 7cm).Results: 19 patients were subjected to lateral chest wallresection. 3 cases underwent partial sternectomies. Resectionwas extended to lungs in 7 cases, diaphragm in 2 cases,vertebral body in 2 cases and clavicle in 2 cases. Reconstructionwas done with polypropylene or titanium mesh and a muscleflap coverage. There was no perioperative mortality. Postoperative complications occurred in 13.6%(n=3). Therewas recurrence in 4 cases within 5 years. 5year disease freesurvival rate was 81.81%.Conclusions: Wide local excision with tumours free marginsstill remains the standard form of therapy. The reconstructiveprocedures have evolved largely to cover the huge defectsfollowing surgery. Post operative adjuvant therapy is guidedby various prognostic factors.