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Expert consensus on resection of chest wall tumors and chest wall reconstruction

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机构: [1]Air Force Med Univ, Tangdu Hosp, Dept Thorac Surg, Xian 710038, Peoples R China [2]Tongji Univ, Shanghai Pulm Hosp, Dept Thorac Surg, Sch Med, Shanghai, Peoples R China [3]Fujian Med Univ, Dept Thorac Surg, Union Hosp, Fuzhou, Peoples R China [4]Tianjin Med Univ Gen Hosp, Lung Canc Inst, Tianjin Key Lab Lung Canc Metastasis & Tumor Micr, Tianjin, Peoples R China [5]Peking Univ Canc Hosp & Inst, Dept Thorac Surg, Key Lab Carcinogenesis & Translat Res, Minist Educ, Beijing, Peoples R China [6]Air Force Med Univ, Tangdu Hosp, Dept Ultrasound Diag, Xian, Peoples R China [7]Guangxi Med Univ, Dept Cardiothorac Surg, Affiliated Hosp 1, Nanning, Peoples R China [8]Xiamen Univ, Dept Thorac Surg, Zhongshan Hosp, Xiamen, Peoples R China [9]Zhejiang Univ, Sch Med, Dept Thorac Surg, Affiliated Hosp 2, Hangzhou, Peoples R China [10]Xi An Jiao Tong Univ, Dept Thorac Surg, Affiliated Hosp 1, Xian, Peoples R China [11]Chinese Acad Med Sci & Peking Union Med Coll, Natl Canc Ctr, Dept Thorac Surg, Natl Clin Res Ctr,Canc Canc Hosp, Beijing, Peoples R China [12]Xi An Jiao Tong Univ, Dept Med Oncol, Affiliated Hosp 1, Xian, Peoples R China [13]Shanxi Med Univ, Dept Thorac Surg, Tumor Hosp, Taiyuan, Peoples R China [14]Army Med Univ, Daping Hosp, Dept Thorac Surg, Chongqing, Peoples R China [15]Univ Elect Sci & Technol China UESTC, Sichuan Canc Hosp & Res Inst, Dept Thorac Surg, Sch Med, Chengdu, Peoples R China [16]Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Dept Minimally Invas Esophageal Surg, Key Lab Canc Prevent & Therapy, Tianjin, Peoples R China [17]Affiliated Hosp Qingdao Univ, Dept Thorac Surg, Qingdao, Peoples R China [18]Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Thorac Surg, Sch Med, Shanghai, Peoples R China [19]Air Force Med Univ, Tangdu Hosp, Dept Plast & Burn Surg, Xian, Peoples R China [20]Peking Univ Third Hosp, Dept Thorac Surg, Beijing, Peoples R China [21]Xi An Jiao Tong Univ, Dept Thorac Surg, Affiliated Hosp 2, Xian, Peoples R China [22]Guangzhou Med Univ, Dept Thorac Surg, Affiliated Hosp 1, Guangzhou, Peoples R China [23]Shanghai Jiao Tong Univ, Shanghai Chest Hosp, Dept Thorac Surg, Sect Esophageal Surg, Shanghai, Peoples R China [24]Qinghai Univ, Dept Thorac & Cadiovasc Surg, Affiliated Hosp, Xining, Peoples R China [25]China Japan Friendship Hosp, Dept Thorac Surg, Beijing, Peoples R China [26]Guangxi Med Univ, Dept Thorac Surg, Tumor Hosp, Nanning, Peoples R China [27]Guizhou Prov Peoples Hosp, Dept Thorac Surg, Guiyang, Peoples R China [28]Tianjin Chest Hosp, Dept Thorac Surg, Tianjin, Peoples R China [29]Nanjing Univ, Dept Cardiothorac Surg, Med Sch, Affiliated Taikang Xianlin Drum Tower Hosp, Nanjing, Peoples R China [30]Zhejiang Univ, Affiliated Hosp 1, Dept Thorac Surg, Sch Med, Hangzhou, Peoples R China [31]Fudan Univ, Zhongshan Hosp, Dept Thorac Surg, Shanghai, Peoples R China [32]Gen Hosp Shenyang Mil Area, Dept Thorac Surg, Shenyang, Peoples R China [33]Chongqing Med Univ, Dept Thorac Surg, Affiliated Hosp 3, Chongqing, Peoples R China [34]Sichuan Univ, West China Hosp, Dept Thorac Surg, Chengdu, Peoples R China [35]Cent South Univ, Hunan Canc Hosp, Xiangya Sch Med, Dept Thorac Surg, Changsha, Peoples R China [36]Cent South Univ, Affiliated Canc Hosp, Xiangya Sch Med, Changsha, Peoples R China [37]Harbin Med Univ Canc Hosp, Dept Thorac Surg & Oncol, Harbin, Peoples R China [38]Hebei Med Univ, Dept Thorac Surg, Hosp 3, Shijiazhuang, Peoples R China [39]Fudan Univ, Shanghai Canc Ctr, Dept Thorac Surg, Shanghai, Peoples R China [40]Harbin Med Univ, Dept Thorac Surg, Affiliated Hosp 2, Harbin, Peoples R China [41]Univ Chinese Acad Sci, Hwa Mei Hosp, Dept Cardiothorac Surg, Ningbo 2 Hosp, Ningbo, Peoples R China [42]Guangdong Prov Peoples Hosp, Guangdong Lung Canc Inst, Guangdong Prov Key Lab Translat Med Lung Canc, Guangzhou, Peoples R China [43]Guangdong Acad Med Sci, Guangzhou, Peoples R China [44]Zuyderland Med Ctr, Dept Surg, Div Gen Thorac Surg, Heerlen, Netherlands [45]Catholic Univ Korea, Coll Med, Dept Thorac & Cardiovasc Surg, Seoul, South Korea [46]Univ Hosp Bari, Dept Emergency & Organ Transplantat, Thorac Surg Unit, Bari, Italy [47]San Luigi Gonzaga Hosp, Dept Oncol, Thorac Surg Div, Orbassano, TO, Italy [48]Klinikum Coburg, Dept Thorac Surg, Coburg, Germany [49]Univ Med Ctr Regensburg, Dept Thorac Surg, Regensburg, Germany [50]Univ Rome Sapienza, Dept Thorac Surg, Policlin Umberto I, Rome, Italy [51]Univ Hosp Parma, Dept Med & Surg, Thorac Surg, Parma, Italy [52]Fukuoka Univ, Sch Med, Dept Gen Thorac Breast & Pediat Surg, Fukuoka, Japan [53]UCL, Royal Natl Orthopaed Hosp, Inst Orthopaed & Musculoskeletal Sci, Div Surg & Intervent Sci, London, England [54]Guys Hosp, Dept Thorac Surg, London, England [55]Kyoto Univ Hosp, Dept Thorac Surg, Kyoto, Japan [56]Univ Modena & Reggio Emilia, Dept Med & Surg Sci, Div Thorac Surg, Modena, Italy [57]Univ Hosp, Dept Thorac Surg, Raemistr, Zurich, Switzerland [58]AUOI Verona, Dept Thorac Surg, Verona, Italy [59]Univ Hosp Leuven, Dept Thorac Surg, Leuven, Belgium [60]Univ Campania Luigi Vanvitelli, Thorac Surg Unit, Naples, Italy [61]San Camillo Forlanini Hosp, Div Thorac Surg, Rome, Italy [62]Univ Pittsburgh Med Ctr, Dept Thorac Surg, Pittsburgh, PA USA [63]S Maria delle Croci Teaching Hosp, Dept Thorac Surg, AUSL Romagna, Ravenna, Italy [64]Aichi Canc Ctr Hosp, Dept Thorac Surg, Nagoya, Aichi, Japan [65]Evang Kliniken Essen Mitte, Dept Thorac Surg, Essen, Germany
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关键词: Chest wall tumor excision margin radiotherapy chest wall reconstruction

摘要:
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.

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 2 区 肿瘤学 2 区 呼吸系统
最新[2023]版:
大类 | 2 区 医学
小类 | 3 区 肿瘤学 3 区 呼吸系统
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Q2 ONCOLOGY Q2 RESPIRATORY SYSTEM
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Q1 RESPIRATORY SYSTEM Q2 ONCOLOGY

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第一作者:
第一作者机构: [1]Air Force Med Univ, Tangdu Hosp, Dept Thorac Surg, Xian 710038, Peoples R China
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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
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