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.
Expert consensus on resection of chest wall tumors and chest wall reconstruction / Lei Wang , Xiaolong Yan, Jinbo Zhao, Chang Chen, Chun Chen, Jun Chen, Ke-Neng Chen, Tiesheng Cao, Ming-Wu Chen, Hongbin Duan, Junqiang Fan, Junke Fu, Shugeng Gao, Hui Guo, Shiping Guo, Wei Guo, Yongtao Han , Ge-Ning Jiang , Hongjing Jiang, Wen-Jie Jiao, Mingqiang Kang, Xuefeng Leng, He-Cheng Li, Jing Li, Jian Li, Shao-Min Li, Shuben Li, Zhigang Li, Zhongcheng Li, Chaoyang Liang, Nai-Quan Mao, Hong Mei, Daqiang Sun, Dong Wang, Luming Wang, Qun Wang, Shumin Wang, Tianhu Wang, Lunxu Liu, Gaoming Xiao, Shidong Xu, Jinliang Yang, Ting Ye, Guangjian Zhang, Linyou Zhang, Guofang Zhao, Jun Zhao, Wen-Zhao Zhong, Yuming Zhu, Karel W E Hulsewé, Yvonne L J Vissers, Erik R de Loos, Jin Yong Jeong, Giuseppe Marulli, Alberto Sandri, Zsolt Sziklavari , Jacopo Vannucci, Luca Ampollini, Yuichiro Ueda , Chaozong Liu , Andrea Bille , Masatsugu Hamaji, Beatrice Aramini, Ilhan Inci , Cecilia Pompili, Hans Van Veer, Alfonso Fiorelli, Ricciardi Sara, Inderpal S Sarkaria, Fabio Davoli, Hiroaki Kuroda, Servet Bölükbas, Xiao-Fei Li, Lijun Huang , Tao Jiang Affiliations expand. - In: TRANSLATIONAL LUNG CANCER RESEARCH. - ISSN 2218-6751. - ELETTRONICO. - 11:(2021), pp. 4057-4083.
Expert consensus on resection of chest wall tumors and chest wall reconstruction.
Beatrice Aramini;
2021
Abstract
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
