Sternal Resection for Sarcoma, Recurrent Breast Cancer, and Radiation-Induced Necrosis

Koppert, Linetta B.; Geel, Albertus N. van; Lans, Titia E.; Pol, Carmen van der; Coevorden, Frits van; Wouters, Michel W. J. M.

doi:10.1016/j.athoracsur.2010.06.044

Cited by 32 publications

(23 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…During the last decade, new methods of surgical treatment and advances in techniques of rigid and musculocutaneous reconstructions have facilitated the treatment of these uncommon tumours (2)(3)(4). The reconstruction of the anterior chest wall is basilar to restore the integrity and rigidity of the anterior thoracic wall, to prevent respiratory impairment, to isolate the mediastinum from infections and to protect the underlying structures by trauma.…”

Section: Introductionmentioning

confidence: 99%

Short and long-term results of sternectomy for sternal tumours

et al. 2017

View full text Add to dashboard Cite

Background: We analyzed our experience in sternal resections (SRs) for primary or secondary neoplasm focusing on technical aspects of reconstruction, post-operative outcomes and long term survival. Methods: From January 2005 to December 2015, 36 patients (24 males, 67%) underwent surgical excision of primary (chondrosarcoma n=18 patients, 50%; osteosarcoma n=2, 6%; Ewing sarcoma n=1, 3%; other n=2, 6%) or secondary (breast cancer n=7, 19%; kidney carcinoma n=2, 6%) sternal tumour. We performed n=30 partial sternectomy and n=6 total sternectomy with en-bloc resection of the sternocostal cartilages in all patient and extended resection in 7 patients. Stability was obtained with prosthetic material, rigid and non-rigid and a muscular flap: rigid material [Strasbourg Thoracic Osteosynthesis System (STRATOS), MedXpert GmbH] and muscle flap n=11 (30.6%); polytetrafluoroethylene patch and muscle flap n=6 (16.7%); muscle flap alone n=19 (52.8%). Results:The 30-day mortality rate was 0, overall complication rate was 19%. The median ICU stay was 1.5 days and mean hospital stay was 10.6±5.9 days. We obtained a complete (R0) resection in all patients. Overall survival (OS) at 5 and 10 years were 59% and 40%; in the group of primary neoplasm OS rate at 5 and 10 years was 79% and 54%. Disease free survival (DFS) rate at 5 years was 61%. Higher grading was identified as negative prognostic factor.Conclusions: Wide radical resections of anterior chest wall are basilar in a multimodality treatment for primary or metastatic neoplasm of the sternum. Stabilization with titanium bars and clips provides rigidity of chest wall with good functional results.

show abstract

Section: Introductionmentioning

confidence: 99%

Short and long-term results of sternectomy for sternal tumours

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Koppert et al conducted a 25-year retrospective study of 68 patients who underwent surgery for complications after breast cancer. Of the 7 patients who did experience radiation-induced necrosis, it was found that the average median time to develop it was 13.5 years [2] The most comparable case in the literature is a 2009 case report by Gerullis et al, which discusses the presentation of a 65-yearold Caucasian lady with a pseudotumoral necrosis 23 years after her primary adenocarcinoma had been resected. However in this case, the mass had gradually increased in size over a period of 10 years-unlike our patient where the presentation was much more of an acute nature.…”

Section: Discussionmentioning

confidence: 93%

“…There is a growing body of evidence for the application of hyperbaric oxygen therapy (HBOT) as an alternative to treat radiation injuries (including radionecrosis of the chest wall) [2,4]. It is thought to work by stimulating angiogenesis and neovascularisation in irradiated tissue which has become hypoxic.…”

Section: Discussionmentioning

confidence: 99%

Radionecrosis 30 Years After Breast Cancer

2014

View full text Add to dashboard Cite

This report describes the case of a 70-year-old woman presenting to outpatient with a several-week history of a painful mass in her right breast, 30 years after her treatment for primary breast cancer. At first, this was suspected to have been a recurrence of her malignancy; however, repeated biopsies ultimately proved this to be negative. Her injury was actually a case of radiotherapy-induced necrosis (radionecrosis) and was subsequently treated with surgical debridement.

show abstract

“…Surgical resection is the preferred treatment with a better prognosis for node-negative patients who experienced local recurrence 1 year after mastectomy [5], but it is not applicable for patients who require full thickness chest wall resection or have a poor skin condition. Therefore, surgical resection is only applicable for a small number of patients [6], and postoperative radiotherapy (RT) or other systemic treatment is required to prevent distant metastasis. Other treatment options such as radiation therapy, chemotherapy, and electrochemical therapy can be considered when surgery is not applicable.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Randomized Clinical Study of the Additive Treatment Effect of Photodynamic Therapy in Breast Cancer Patients with Chest Wall Recurrence

et al. 2014

View full text Add to dashboard Cite

PurposeThis study investigated the additive effect of photodynamic therapy (PDT) plus traditional radiotherapy (RT) for patients with breast cancer and chest wall recurrence.MethodsA total of 40 patients with recurrent breast cancer were prospectively randomized to receive RT alone (group A, n=20) or PDT and RT in combination (group B, n=20). Traditional RT at a dose of 50 Gy was delivered in 25 fractions with or without exposure to 5-aminolevulinic acid and red light as PDT.ResultsThe response rates were not statistically different between the groups, but more patients achieved a complete response (CR) in group B (50%) than in group A (20%). The median time to CR in group B was significantly shorter than that in group A (109.6 days vs. 175.2 days, p=0.001). Adverse event profiles were not different between the groups.ConclusionAn additive antitumor effect is demonstrated with additional PDT to RT. This combination therapy might reduce the duration of exposure to RT, but further investigation is warranted.

show abstract

Sternal Resection for Sarcoma, Recurrent Breast Cancer, and Radiation-Induced Necrosis

Cited by 32 publications

References 36 publications

Short and long-term results of sternectomy for sternal tumours

Short and long-term results of sternectomy for sternal tumours

Radionecrosis 30 Years After Breast Cancer

A Pilot Randomized Clinical Study of the Additive Treatment Effect of Photodynamic Therapy in Breast Cancer Patients with Chest Wall Recurrence

Contact Info

Product

Resources

About