Chest wall tumors are a relatively uncommon disease in clinical practice. Most of the published studies about chest wall tumors are usually single-center retrospective studies, involving few patients. Therefore, evidences regarding clinical conclusions about chest wall tumors are lacking, and some controversial issues have still to be agreed upon. In January 2019, 73 experts in thoracic surgery, plastic surgery, science, and engineering jointly released the Chinese Expert Consensus on Chest Wall Tumor Resection and Chest Wall Reconstruction (2018 edition). After that, numerous experts put forward new perspectives on some academic issues in this version of the consensus, pointing out the necessity to further discuss the points of contention. Thus, we conducted a survey through the administration of a questionnaire among 85 experts in the world. Consensus has been reached on some major points as follows. (I) Wide excision should be performed for desmoid tumor (DT) of chest wall. After excluding the distant metastasis by multi-disciplinary team, solitary sternal plasmacytoma can be treated with extensive resection and adjuvant radiotherapy. (II) Wide excision with above 2 cm margin distance should be attempted to obtain R0 resection margin for chest wall tumor unless the tumor involves vital organs or structures, including the great vessels, heart, trachea, joints, and spine. (III) For patients with chest wall tumors undergoing unplanned excision (UE) for the first time, it is necessary to carry out wide excision as soon as possible within 1-3 months following the previous surgery. (IV) Current Tumor Node Metastasis staging criteria (American Joint Committee on Cancer) of bone tumor and soft tissue sarcoma are not suitable for chest wall sarcomas. (V) It is necessary to use rigid implants for chest wall reconstruction once the maximum diameter of the chest wall defect exceeds 5 cm in adults and adolescents. (VI) For non-small cell lung cancer (NSCLC) invading the chest wall, wide excision with neoadjuvant and/or adjuvant therapy are recommended for patients with stage T3-4N0-1M0. As clear guidelines are lacking, these consensus statements on controversial issues on chest wall tumors and resection could possibly serve as further guidance in clinical practice during the upcoming years.
基金:
National Key R&DProgram of China [2018YFE0207900]; Top-notch project of medical science and technology for youth cultivation of the army [18QNP028]; Clinical Development Innovation Fund of Air Force Medical University [2021XB024]; Lingyun Program of Air Force Medical University [2019cyjhwl]; Zhufeng program of Air Force Medical University [2019rcfcyxl]; Key R&D Program of Guangdong Province [2018B090906001]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [51835010]
第一作者机构:[1]Air Force Med Univ, Tangdu Hosp, Dept Thorac Surg, Xian 710038, Peoples R China
共同第一作者:
通讯作者:
通讯机构:[1]Air Force Med Univ, Tangdu Hosp, Dept Thorac Surg, Xian 710038, Peoples R China[*1]Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi’an 710038, China
推荐引用方式(GB/T 7714):
Wang Lei,Yan Xiaolong,Zhao Jinbo,et al.Expert consensus on resection of chest wall tumors and chest wall reconstruction[J].TRANSLATIONAL LUNG CANCER RESEARCH.2021,10(11):4057-4083.doi:10.21037/tlcr-21-935.
APA:
Wang, Lei,Yan, Xiaolong,Zhao, Jinbo,Chen, Chang,Chen, Chun...&Jiang, Tao.(2021).Expert consensus on resection of chest wall tumors and chest wall reconstruction.TRANSLATIONAL LUNG CANCER RESEARCH,10,(11)
MLA:
Wang, Lei,et al."Expert consensus on resection of chest wall tumors and chest wall reconstruction".TRANSLATIONAL LUNG CANCER RESEARCH 10..11(2021):4057-4083