PDF(Pubmed)
Abstract：
Sarcomas of the chest wall are rare and their current treatment regimen is diverse and complex due to the heterogeneity of these tumors as well as the variations in tumor location and extent. They only account for 0.04% of newly diagnosed cancers of whom about 45% comprise soft tissue sarcomas. Larger cohort studies are scarce and often focus on one specific treatment item. We therefore aim to provide helicopter view for clinicians treating patients with sarcomas of the chest wall, focusing mainly on soft tissue sarcomas. This overview includes the value of neoadjuvant systemic or radiotherapy, surgical resection, approaches for thoracic wall reconstruction, and the need for follow-up. Provided the heterogeneity and relative rarity, we recommend that treatment decisions in soft tissue sarcoma of the chest wall are discussed in a multidisciplinary tumor board at a reference sarcoma center or within sarcoma networks to ensure personalized, rational decision making. A surgical oncologist specialized in sarcoma surgery is crucial, and for extensive resections involving the thoracic cavity we recommend involvement of a thoracic surgeon. In addition, a specialized medical- and radiation oncologist as well as a plastic surgeon is required to ensure the best multimodality treatment plan to optimize patient outcome.
摘要：
由于这些肿瘤的异质性以及肿瘤位置和范围的变化，胸壁肉瘤很少见，并且其当前的治疗方案多种多样且复杂。它们仅占新诊断癌症的0.04％，其中约45％包括软组织肉瘤。大型队列研究很少，通常集中在一个特定的治疗项目上。因此，我们的目标是为治疗胸壁肉瘤患者的临床医生提供直升机视野，主要集中于软组织肉瘤。本概述包括新辅助系统或放疗的价值，手术切除,胸壁重建的方法，以及后续行动的必要性。如果存在异质性和相对稀有性，我们建议在参考肉瘤中心的多学科肿瘤委员会或肉瘤网络内讨论胸壁软组织肉瘤的治疗决策，以确保个性化。理性决策。专门从事肉瘤手术的外科肿瘤学家至关重要，对于涉及胸腔的广泛切除，我们建议胸外科医师参与。此外,需要专门的医学和放射肿瘤学家以及整形外科医生，以确保最佳的多模态治疗计划，以优化患者的预后。
