Sternal tumors surgery: extent of resection, type of reconstruction and survival

Abstract

Methods A total of 32 patients (11 males, 21 females, mean age 51.9 years) were operated on during a 7 years period in two institutions. There were 16 sarcomas (9 chondrosarcomas, 3 radiation-induced sarcomas, 2 Ewing sarcoma, 2 osteosarcoma), 1 recurrent desmoid tumor, 3 local breast cancer recurrences, 1 plasmocytoma, and 11 metastatic tumors (5 from breast cancer, 2 rabdomyosarcoma, 2 liposarcoma, 1 NSCLC, 1 prostate cancer). Four-five cm free margins on each side were achieved in all patients with total sternectomy (13), subtotal sternal resection (17), and partial resection (2). Concurrent en bloc resections included anterior ribs (7), clavicle (6), pericardium (2), brachiocephalic vein (2), and diaphragm (1). The chest was reconstructed with Gore-tex (5) or Marlex mesh (22) and myocutaneous flap in 18 (56.25%) patients or omentum in 6 (18.75%) patients. Only double layer Marlex mesh with breast mobilization was performed in 5 women (15.62%). Combination of prostetic material and metal bars or wires was needed in 6 patients after total sternectomy (18.75%). Multimodality treatment preor postoperatively was administered in most of the patients.