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. 2020 Dec:4:329-331.
doi: 10.1016/j.xjtc.2020.08.014. Epub 2020 Aug 15.

Complex chest wall surgery to prevent vascular complications after immunotherapy and radiation treatment

James J Choi  1 , Robert J Allen Jr  2 , Manjit S Bains  1 , Marc A Cohen  3 , Yao Yu  4 , Nassrene Elmadhun  1 , David R Jones  1 , Gaetano Rocco  1
Affiliations

Complex chest wall surgery to prevent vascular complications after immunotherapy and radiation treatment

James J Choi et al. JTCVS Tech. 2020 Dec.

Abstract

Chest wall surgery after immunotherapy and radiation can provide cure, prevent catastrophic complications, reduce the duration of immunotherapy, and allow verification of depth of response to therapy.

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Conflict of interest statement

Disclosures: Dr Rocco has financial relationships with Scanlan. Dr Jones serves as a senior medical advisor for Diffusion Pharmaceuticals and a consultant for Merck and AstraZeneca. All other authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest.

Figures

None
Tumor seen before immunotherapy and radiation and then at the time of surgical resection.
Figure 1
Figure 1
Computed tomography scan of the chest shows the sizeable mass of the right chest wall and thoracic inlet. Top panel, There is exposed soft tissue and muscle with focal destruction of the manubrium, as well as almost complete destruction of the right clavicle. The close proximity of tumor to the common carotid artery and the brachiocephalic vein can be seen. Bottom panel, The near-complete destruction of the right clavicle is observed.
Figure 2
Figure 2
Despite marked reduction in tumor size with immunotherapy and radiation, a complex surgical resection was necessary. Left panel, The surgical resection bed is seen after removal of the tumor, with the right subclavian and internal jugular vein in view, with the apex of the right lung and cut edges of the anterior left ribs. Right panel, The acellular collagen matrix patch sutured around the fourth rib and the lateral cut ends of ribs 2 and 3 on the right, and the anterior ribs 2 and 3, as well as the sternoclavicular joint on the left.
See this image and copyright information in PMC

Comment in

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