• Courtney J Harris, Irene Helenowski, Andrew J Murphy, Sara A Mansfield, Michael P LaQuaglia, Todd E Heaton, Michele Cavalli, Joseph T Murphy, Erika A Newman, Richard E Overmen, Tanvi T Kartal, J Cooke-Barber, Addison Donaher, Marcus M Malek, Ranjeet Kalsi, Eugene S Kim, Michael J Zobel, Catherine J Goodhue, Bindi J Naik-Mathuria, Imory N Jefferson, Jonathan P Roach, Claudia Mata, Nelson Piché, Shahrzad Joharifard, Serge Sultan, Scott S Short, Rebecka L Meyers, Josh Bleicher, Hau D Le, Kevin Janek, Andreana Bütter, Jacob Davidson, Jennifer H Aldrink, Holden W Richards, Elisabeth T Tracy, Sarah J Commander, Elizabeth A Fialkowski, Misty Troutt, Roshni Dasgupta, and Timothy B Lautz.
• Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
• Ann. Surg. 2022 Dec 1; 276 (6): e969e975e969-e975.

ObjectiveTo determine the impact of tumor characteristics and treatment approach on (1) local recurrence, (2) scoliosis development, and (3) patient-reported quality of life in children with sarcoma of the chest wall.Summary Of Background DataChildren with chest wall sarcoma require multimodal therapy including chemotherapy, surgery, and/or radiation. Despite aggressive therapy which places them at risk for functional impairment and scoliosis, these patients are also at significant risk for local recurrence.MethodsA multi-institutional review of 175 children (median age 13 years) with chest wall sarcoma treated at seventeen Pediatric Surgical Oncology Research Collaborative institutions between 2008 and 2017 was performed. Patient-reported quality of life was assessed prospectively using PROMIS surveys.ResultsThe most common diagnoses were Ewing sarcoma (67%) and osteosarcoma (9%). Surgical resection was performed in 85% and radiation in 55%. A median of 2 ribs were resected (interquartile range = 1-3), and number of ribs resected did not correlate with margin status ( P = 0.36). Local recurrence occurred in 23% and margin status was the only predictive factor(HR 2.24, P = 0.039). With a median follow-up of 5 years, 13% developed scoliosis (median Cobb angle 26) and 5% required corrective spine surgery. Scoliosis was associated with posteriorrib resection (HR 8.43; P= 0.003) and increased number of ribs resected (HR 1.78; P = 0.02). Overall, patient-reported quality of life is not impaired after chest wall tumor resection.ConclusionsLocal recurrence occurs in one-quarter of children with chest wall sarcoma and is independent of tumor type. Scoliosis occurs in 13% of patients, but patient-reported quality of life is excellent.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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