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. 2015 Jul;100(1):215-21; discussion 221-2.
doi: 10.1016/j.athoracsur.2015.03.013. Epub 2015 May 20.

Resection of Primary and Secondary Tumors of the Sternum: An Analysis of Prognostic Variables

Usman Ahmad  1 , Haoxian Yang  2 , Camelia Sima  1 , Daniel H Buitrago  1 , R Taylor Ripley  1 , Kei Suzuki  1 , Manjit S Bains  1 , Nabil P Rizk  1 , Valerie W Rusch  1 , James Huang  1 , Prasad S Adusumilli  1 , Gaetano Rocco  3 , David R Jones  4
Affiliations

Resection of Primary and Secondary Tumors of the Sternum: An Analysis of Prognostic Variables

Usman Ahmad et al. Ann Thorac Surg. 2015 Jul.

Abstract

Background: We sought to determine the prognostic variables associated with overall survival (OS) and recurrence-free probability (RFP) in patients with primary and secondary sternal tumors treated with surgical resection.

Methods: A retrospective analysis of patients who underwent resection of primary or secondary sternal tumors at 2 cancer institutes between 1995 and 2013 was performed. OS and RFP were estimated using the Kaplan-Meier method, and predictors of OS and RFP were analyzed using the Cox proportional hazards model.

Results: Sternal resection was performed in 78 patients with curative (67 [86%]) or palliative (6 [8%]) intent. Seventy-three patients (94%) had malignant tumors, of which 28 (36%) were primary and 45 (57%) were secondary malignancies. Sternal resections were complete in 13 patients (17%) and partial in 65 (83%). There were no perioperative deaths, and grade III/IV complications were noted in 17 patients (22%). The 5-year OS was 80% for patients with primary malignant tumors, 73% for patients with nonbreast secondary malignant tumors, and 58% for patients with breast tumors (p = 0.85). In the overall cohort, R0 resection was associated with prolonged 5-year OS (84% vs 20%) on univariate (p = 0.004) and multivariate (adjusted hazard ratio, 3.37; p = 0.029) analysis. On subgroup analysis, R0 resection was associated with improved OS and RFP only for patients with primary malignant tumors.

Conclusions: Sternal resection can achieve favorable OS for patients with primary and secondary sternal tumors. R0 resection is associated with improved 5-year OS and RFP in patients with primary malignant tumors. We did not detect a similar effect in patients with breast or nonbreast secondary tumors.

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Figures

Figure 1
Figure 1
Survival outcomes after resection of malignant sternal tumor, according to tumor type.A, Overall survival after resection of sternal tumor (p=0.59). B, Recurrence-free probability after resection of sternal tumor (p=0.06).
Figure 2
Figure 2
Survival outcomes after resection for primary malignant tumor, as a function of completeness of resection. A, Overall survival after resection of sternal tumor (p<0.001).B, Recurrence-free probability after resection of sternal tumor (p=0.003).
See this image and copyright information in PMC

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References

    1. Martini N, Huvos AG, Burt ME, Heelan RT, Bains MS, McCormack PM, Rusch VW, Weber M, Downey RJ, Ginsberg RJ. Predictors of survival in malignant tumors of the sternum. J Thorac Cardiovasc Surg. 1996;111:96–105. - PubMed
    1. Incarbone M, Nava M, Lequaglie C, Ravasi G, Pastorino U. Sternal resection for primary or secondary tumors. J Thorac Cardiovasc Surg. 1997;114:93–9. - PubMed
    1. Chapelier AR, Missana MC, Couturaud B, Fadel E, Fabre D, Mussot S, Pouillart P, Dartevelle PG. Sternal resection and reconstruction for primary malignant tumors. Ann Thorac Surg. 2004;77:1001–6. - PubMed
    1. Walsh GL, Davis BM, Swisher SG, Vaporciyan AA, Smythe WR, Willis-Merriman K, Roth JA, Putnam JB., Jr A single-institutional, multidisciplinary approach to primary sarcomas involving the chest wall requiring full-thickness resections. J Thorac Cardiovasc Surg. 2001;121:48–60. - PubMed
    1. Koppert LB, van Geel AN, Lans TE, van der Pol C, van Coevorden F, Wouters MW. Sternal resection for sarcoma, recurrent breast cancer, and radiation-induced necrosis. Ann Thorac Surg. 2010;90:1102–1108. - PubMed

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