Resection of primary and secondary tumors of the sternum: An analysis of prognostic variables Journal Article

Authors: Ahmad, U.; Yang, H.; Sima, C.; Buitrago, D. H.; Ripley, R. T.; Suzuki, K.; Bains, M. S.; Rizk, N. P.; Rusch, V. W.; Huang, J.; Adusumilli, P. S.; Rocco, G.; Jones, D. R.
Article Title: Resection of primary and secondary tumors of the sternum: An analysis of prognostic variables
Abstract: Background We sought to determine the prognostic variables associated with overall survival (OS) and recurrence-free probability (RFP) in patients with primary and secondary sternal tumors treated with surgical resection. Methods A retrospective analysis of patients who underwent resection of primary or secondary sternal tumors at 2 cancer institutes between 1995 and 2013 was performed. OS and RFP were estimated using the Kaplan-Meier method, and predictors of OS and RFP were analyzed using the Cox proportional hazards model. Results Sternal resection was performed in 78 patients with curative (67 [86%]) or palliative (6 [8%]) intent. Seventy-three patients (94%) had malignant tumors, of which 28 (36%) were primary and 45 (57%) were secondary malignancies. Sternal resections were complete in 13 patients (17%) and partial in 65 (83%). There were no perioperative deaths, and grade III/IV complications were noted in 17 patients (22%). The 5-year OS was 80% for patients with primary malignant tumors, 73% for patients with nonbreast secondary malignant tumors, and 58% for patients with breast tumors (p = 0.85). In the overall cohort, R0 resection was associated with prolonged 5-year OS (84% vs 20%) on univariate (p = 0.004) and multivariate (adjusted hazard ratio, 3.37; p = 0.029) analysis. On subgroup analysis, R0 resection was associated with improved OS and RFP only for patients with primary malignant tumors. Conclusions Sternal resection can achieve favorable OS for patients with primary and secondary sternal tumors. R0 resection is associated with improved 5-year OS and RFP in patients with primary malignant tumors. We did not detect a similar effect in patients with breast or nonbreast secondary tumors. © 2015 The Society of Thoracic Surgeons.
Keywords: adult; cancer surgery; primary tumor; major clinical study; overall survival; conference paper; breast cancer; delirium; retrospective study; age; pneumonia; postoperative complication; probability; breast tumor; surgical infection; malignant neoplastic disease; benign tumor; heart arrhythmia; leiomyosarcoma; postoperative hemorrhage; sternotomy; chondrosarcoma; vocal cord paralysis; thorax tumor; acute coronary syndrome; tumor invasion; cancer prognosis; human; male; female; priority journal
Journal Title: Annals of Thoracic Surgery
Volume: 100
Issue: 1
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 2015-07-01
Start Page: 215
End Page: 222
Language: English
DOI: 10.1016/j.athoracsur.2015.03.013
PROVIDER: scopus
PUBMED: 26002443
PMCID: PMC4634707
Notes: Presented at the 61st Annual Meeting of the Southern Thoracic Surgical Association, Tucson, AZ, 2014 Nov 5–8 -- Export Date: 3 August 2015 -- Source: Scopus
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MSK Authors
  1. Camelia S Sima
    204 Sima
  2. Valerie W Rusch
    651 Rusch
  3. Nabil Rizk
    134 Rizk
  4. James Huang
    119 Huang
  5. Kei Suzuki
    28 Suzuki
  6. Manjit S Bains
    227 Bains
  7. Robert Taylor Ripley
    7 Ripley
  8. Usman Ahmad
    9 Ahmad
  9. David Randolph Jones
    152 Jones
  10. Haoxian   Yang
    3 Yang