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Chest wall resection and reconstruction for neoplastic diseases has unique oncologic, structural, and functional challenges. In a young and fit patient with a mediastinal mass and extensive anterior chest wall invasion, purely structural solutions were deemed insufficient. We hereby present a novel three-dimensionally printed patient-specific titanium implant of sternum and ribs. This osteointegrable implant was designed with biomechanical capabilities using a unique "Greek wave" folding pattern. Postoperative dynamic computed tomography showed that the implant allowed for controlled flexing during the respiratory cycle. Three-dimensional printing with biocompatible materials could enable a new generation of chest wall implants strongly focused on functional reconstruction.

The findings reported here indicate that neoadjuvant chemotherapy or chemoradiotherapy followed by surgery (preferably lobectomy) yields better OS and PFS than definitive chemoradiotherapy in patients with resectable stage IIIA-N2 NSCLC.