Full-thickness chest wall resection for locally recurrent XXXX .

@entity1 @entity5 @entity797 @entity0
AIM: In spite of available recommendations, therapeutic procedures of locally recurrent @entity0 are very different. In a retrospective study, the possibilities and results of complete, full-thickness chest wall resection are presented. METHODS: Between 1985 and 2004, 51 @entity1 underwent complete, full-thickness chest wall resection with primary coverage. Primary surgical therapy of @entity0 had been mastectomy in 88%. Median age of @entity1 undergoing surgery for a local recurrence was 57 (29 - 81) years. The median interval between surgery of the primary @entity5 and of the local recurrence was 70.3 (10.7 - 327.2) months; median follow-up was 29.4 (1.8 - 230.9) months. 40 (78.4%) @entity1 required rib resections, 15 (29.4%) of them in combination with partial sternal resection. In 4 (7.8%) @entity1 complete and in 7 (13.7%) @entity1 partial sternal resection without additional rib resection were performed.Coverage was mainly realized using latissimus dorsi myocutaneous flaps (n=44; 86.3%). Survival rates were calculated by means of the Kaplan-Meier method, the relative risk using univariate and multivariate @entity797 -regression analysis. RESULTS: In the total collective, cumulative 5-, 10- and 15-year survival (YS) rates were 39%, 31% and 23%, respectively, median survival 46.4 months. R0 resection was associated with a 5-YS of 42%. Prognostic factors were age at the time of primary surgery, disease-free interval and @entity5 invasion of bony structures. Mortality was 2%, morbidity 35%. CONCLUSION: Full-thickness chest wall resection of locally recurrent @entity0 is possible in almost any @entity1 when performed by a team of thoracic and plastic surgeons. Only radical resection provides good long-term results with low mortality and morbidity.
