• Alina-Maria Budacan, Akshay J Patel, Pavithra Babu, Haitham Khalil, Sumathi Vaiyapuri, Michael Parry, and Maninder S Kalkat.
• Department of Thoracic Surgery, University Hospitals Birmingham, Birmingham, UK.
• J. Thorac. Cardiovasc. Surg. 2024 Sep 25.

ObjectivesWe aimed to analyze survival, predictors of outcome and the long-term functional status of patients with a diagnosis of primary chest wall sarcoma who undergo chest wall resection and reconstruction (CWRR).MethodsWe analysed a prospectively maintained database, including all patients operated on between 2008-2021. The primary outcome measures were overall and disease-free survival and analyses were employed to determine the risk factors for poor survival and recurrence.ResultsOne hundred and thirty-nine patients included, 55% were male. The majority (96%) had an R0 resection and 75.1% had no post-operative complications up to 30 days post procedure; median length of hospital stay was 7 (6-10) days. Median overall and disease-free survival (DFS) was 58.8 and 53.6 months respectively. For those alive, at long-term follow-up, 80% had a Medical Research Council (MRC) dyspnoea score of 0 and Karnofsky index >80%. Survival and mortality rates were better in chondrosarcomas compared to non-chondromatous sarcomas (p<0.05). Previous history of radiotherapy, previous history of cancer, the type of sarcoma (Ewing's or soft tissue), the need for adjuvant treatment and tumour grade were significant predictors of mortality and recurrence on univariate testing. Extended resection, a higher number of ribs removed, and the incidence of post-operative complications were significantly associated with a worse post-operative MRC score.ConclusionsCareful patient selection and multi-disciplinary decision-making is crucial. This leads to clear resection margins, good overall and disease-free survival and good functional outcomes.Copyright © 2024. Published by Elsevier Inc.

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