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Implications of Tumor Characteristics and Treatment Modality on Local Recurrence and Functional Outcomes in Children With Chest Wall Sarcoma: A Pediatric Surgical Oncology Research Collaborative Study.

Publication ,  Journal Article
Harris, CJ; Helenowski, I; Murphy, AJ; Mansfield, SA; LaQuaglia, MP; Heaton, TE; Cavalli, M; Murphy, JT; Newman, EA; Overmen, RE; Kartal, TT ...
Published in: Ann Surg
December 1, 2022

OBJECTIVE: To 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 DATA: Children 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. METHODS: A 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. RESULTS: The 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. CONCLUSIONS: Local 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.

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Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

December 1, 2022

Volume

276

Issue

6

Start / End Page

e969 / e975

Location

United States

Related Subject Headings

  • Thoracic Wall
  • Thoracic Neoplasms
  • Surgical Oncology
  • Surgery
  • Scoliosis
  • Sarcoma
  • Retrospective Studies
  • Quality of Life
  • Humans
  • Child
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Harris, C. J., Helenowski, I., Murphy, A. J., Mansfield, S. A., LaQuaglia, M. P., Heaton, T. E., … Lautz, T. B. (2022). Implications of Tumor Characteristics and Treatment Modality on Local Recurrence and Functional Outcomes in Children With Chest Wall Sarcoma: A Pediatric Surgical Oncology Research Collaborative Study. Ann Surg, 276(6), e969–e975. https://doi.org/10.1097/SLA.0000000000004579
Harris, Courtney J., Irene Helenowski, Andrew J. Murphy, Sara A. Mansfield, Michael P. LaQuaglia, Todd E. Heaton, Michele Cavalli, et al. “Implications of Tumor Characteristics and Treatment Modality on Local Recurrence and Functional Outcomes in Children With Chest Wall Sarcoma: A Pediatric Surgical Oncology Research Collaborative Study.Ann Surg 276, no. 6 (December 1, 2022): e969–75. https://doi.org/10.1097/SLA.0000000000004579.
Harris CJ, Helenowski I, Murphy AJ, Mansfield SA, LaQuaglia MP, Heaton TE, Cavalli M, Murphy JT, Newman EA, Overmen RE, Kartal TT, Cooke-Barber J, Donaher A, Malek MM, Kalsi R, Kim ES, Zobel MJ, Goodhue CJ, Naik-Mathuria BJ, Jefferson IN, Roach JP, Mata C, Piché N, Joharifard S, Sultan S, Short SS, Meyers RL, Bleicher J, Le HD, Janek K, Bütter A, Davidson J, Aldrink JH, Richards HW, Tracy ET, Commander SJ, Fialkowski EA, Troutt M, Dasgupta R, Lautz TB. Implications of Tumor Characteristics and Treatment Modality on Local Recurrence and Functional Outcomes in Children With Chest Wall Sarcoma: A Pediatric Surgical Oncology Research Collaborative Study. Ann Surg. 2022 Dec 1;276(6):e969–e975.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

December 1, 2022

Volume

276

Issue

6

Start / End Page

e969 / e975

Location

United States

Related Subject Headings

  • Thoracic Wall
  • Thoracic Neoplasms
  • Surgical Oncology
  • Surgery
  • Scoliosis
  • Sarcoma
  • Retrospective Studies
  • Quality of Life
  • Humans
  • Child