2019 Volume 55 Issue 1 Pages 47-52
Purpose: We investigated the relationship between tumor resection margins and the clinical course of soft tissue sarcomas of the chest wall in children.
Methods: We enrolled seven pediatric patients who visited our department from 1994 to 2015 in this retrospective study of treatment outcomes. The patients all had primary soft tissue sarcomas of the chest wall and underwent radical resection after induction chemotherapy or induction chemotherapy and radiotherapy. We examined their resection margins and the outcomes of treatment.
Results: All six patients without distant metastasis achieved disease-free survival. Three patients who underwent wide resection did not undergo radiation therapy as their initial treatment. Two patients, one with undifferentiated round cell sarcoma and a 2 cm resection margin and the other with primitive neuroectodermal tumor (PNET) and a 1 cm resection margin did not develop recurrences. However, one patient with synovial sarcoma and a 1 cm resection margin developed local recurrence. None of the three patients who underwent combined marginal resection and radiotherapy (two with PNET and one with rhabdomyosarcoma) experienced disease recurrence. Three patients underwent chest wall reconstructions without serious complications. The 5-year overall survival for all the seven patients was 85.7%, and the 5-year event-free survival was 71.4%. Only one patient with PNET who had distant metastases present at the initial visit died.
Conclusions: In patients without distant metastases, 2 cm resection margins may be sufficient for omitting radiotherapy. Chest wall reconstruction can be considered a safe and effective means of broadening the possibility of extensive resection.
