The Role of Surgery in Primary Chest Wall Tumors - Over 20 Years' Experience in Resection and Reconstruction

Sep 28, 2026

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Primary chest wall tumors represent a rare, heterogeneous group arising from soft tissues and bones. Surgical excision is standard for benign disease, whereas malignant tumors require multimodal strategies. This study performs a predictive analysis of outcome, recurrence-free survival, and overall survival using retrospective clinical and pathological records from 1998–2020. Results describe outcomes in 53 treated patients and identify tumor diameter, postoperative complications, and high malignancy grade as prognostic factors, emphasizing complete resection with healthy margins within a comprehensive approach.

LanguageEnglish

CategoryHealthcare

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Pages16

Reading Time40 min

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Introduction

Materials and Methods

cancers Article The Role of Surgery in Primary Chest Wall Tumors: Over 20 Years' Experience in Resection and Reconstruction Giorgio Lo Iacono 1, *, Antonio Mazzella 1, Shehab Mohamed 1, Francesco Petrella 1,2, Giulia Sedda 1, Monica Casiraghi 1,2, Lara Girelli 1, Luca Bertolaccini 1 and Lorenzo Spaggiari 1,2 Citation: Lo Iacono, G.; Mazzella, A.; Mohamed, S.; Petrella, F.; Sedda, G.; Casiraghi, M.; Girelli, L.; Bertolaccini, L.; Spaggiari, L. The Role of Surgery in Primary Chest Wall Tumors: Over 20 Years' Experience in Resection and Reconstruction. Cancers 2023, 15, 2153. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)cancers15072153 Academic Editor: Marcello Tiseo Received: 15 March 2023 Revised: 30 March 2023 Accepted: 31 March 2023 Published: 5 April 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; [lorenzo.spaggiari@ieo.it](lorenzo.spaggiari@ieo.it) (L.S.) 2 Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy * Correspondence: [giorgio.loiacono@ieo.it](giorgio.loiacono@ieo.it) Simple Summary: Primary chest wall tumors comprise a group of rare tumors for which the best treatment method has yet to be determined. As surgeons, we wanted to explore our role in approaching these pathologies to analyze the role of surgery amidst other oncological considerations. It is clear that radical oncological surgery is an essential element of a multidisciplinary approach. Abstract: Background: Primary chest wall tumors comprise a heterogeneous group of neoplasms arising from soft tissues and bones. While surgical excision is the standard of care for benign tumors, the management of malignant tumors requires multimodal treatment. We conducted a predictive analysis of outcome, recurrence-free and overall survival. Methods: We retrospectively reviewed the clinical and pathological records of all patients treated in our center between 1998 and 2020 . Results: 53 patients (15–85 years) were treated in our department. The average tumor diameter was 65 􀀆 35 mm (10–160 mm) . Negative margins were obtained in 48 patients (90.6%), whereas in the remaining 5, R1 resection was accomplished. Median overall survival was 63,03 months (1–282 months) . Overall survival was 90% at 1 year, 78% at 2 years, and 61% at 5 years. Our analysis identiﬁed tumor diameter, postoperative complications, and high grade of malignancy as factors that can inﬂuence prognosis. Conclusions: The treatment of primary chest wall tumors remains avery challenging process. Different histological types preclude deﬁnition of an unequivocal approach. Complete resection with healthy margins remains a deﬁnitive cornerstone in the treatment of these cancers as part of a more comprehensive approach. Keywords: chest wall; sternum; ribs; chondrosarcoma; sarcoma; reconstruction 1. Introduction It is believed that Osias Aimar was the ﬁrst to perform, in 1778 [1], the resection of a chest wall tumor. Primary chest wall tumors comprise a heterogeneous group of neoplasms arising from soft tissues and bones of the chest. They are rare tumors, representing around 5% of all thoracic neoplasms [1–3] . They are classiﬁed based on histology type and clinical behavior. Benign lesions arising from the thoracic district are more often represented by Osteochondromas (50%), Chondromas, Fibrous dysplasia, and Desmoid tumors [1] . Sarcomas dominate malignant pathology. Chondrosarcomas are the most common primary chest wall tumors, followed by Ewing sarcoma and Askin's tumors [4] . Patients typically re

FAQs

What is the main clinical question of the study on primary chest wall tumors?

The study evaluates which factors influence early and long-term outcomes and relapse, focusing on the surgical role within multidisciplinary oncologic care.

How were patients and data handled in this research?

Researchers retrospectively reviewed clinical and pathological records of all patients treated at the center between 1998 and 2020, conducted according to the Declaration of Helsinki recommendations.

Which factors were identified as influencing prognosis and survival?

The analysis identified tumor diameter, postoperative complications, and high grade of malignancy as factors that can influence prognosis, with survival outcomes reported across 1-, 2-, and 5-year intervals.

Sep 28, 2026

Uploaded by Eliana