초록접수 현황
| 20F-154 | 구연 발표 |
Surgical treatment of sternal metastasis or radionecrosis for breast cancer: Case series of 5 patients
Hee Chul Yang 1, Keun Seok Lee 2, Eun Sook Lee 2, Jin Ho Choi 1, Moon Soo Kim 1, Jong Mog Lee 1
1 Department of Thoracic Surgery, National Cancer Center, Goyang, Republic of Korea
2 Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea
Purpose : Owing to its extensive chest wall resection and complexity of reconstruction, treatment of sternal metastasis or radionecrosis has been challenging in patients with advanced breast cancer. We report the surgical outcome and our sternal reconstruction technique.
Methods : Five consecutive patients underwent radical anterior chest wall resection including partial (n=4) or total (n=1) sternum for sternal metastasis (n=2) and combined radionecrosis (n=3) after breast radiotherapy during the past 5 years. We used titanium plates in combination with Gore-Tex® patch or XCM BIOLOGIC® Tissue Matrix to restore the function and shape of the original chest wall. LD myocutaneous flap (n=2), full-thickness skin graft (n=1), lung lobectomy (n=1), wedge resection (n=1), pericardial resection and reconstruction (n=2) were concomitantly performed. Curative-intent (n=3) and debulking (n=2) resection were performed.
Results : In the cases of requiring LD myocutaneous flap, the mean operation time was 11.3 hours, and for the other cases, it was 4.5 hours. There were two reoperations due to paradoxical respiration and wound infection. The mean hospital stay was 22.8 (R: 8-49) days. All patients were discharged with normal breathing and clean wound conditions. Out of 3 patients who underwent curative surgery, one patient had no recurrence, and 2 patients proceeded to local or distant recurrences. All the patients are still alive with the mean follow-up period of 23 (R: 3.7-67.1) months.
Conclusion : As the technique of sternal reconstruction develops, the surgical approach can be more aggressively applied to breast cancer patients who are not resolved by chemoradiotherapy.
Methods : Five consecutive patients underwent radical anterior chest wall resection including partial (n=4) or total (n=1) sternum for sternal metastasis (n=2) and combined radionecrosis (n=3) after breast radiotherapy during the past 5 years. We used titanium plates in combination with Gore-Tex® patch or XCM BIOLOGIC® Tissue Matrix to restore the function and shape of the original chest wall. LD myocutaneous flap (n=2), full-thickness skin graft (n=1), lung lobectomy (n=1), wedge resection (n=1), pericardial resection and reconstruction (n=2) were concomitantly performed. Curative-intent (n=3) and debulking (n=2) resection were performed.
Results : In the cases of requiring LD myocutaneous flap, the mean operation time was 11.3 hours, and for the other cases, it was 4.5 hours. There were two reoperations due to paradoxical respiration and wound infection. The mean hospital stay was 22.8 (R: 8-49) days. All patients were discharged with normal breathing and clean wound conditions. Out of 3 patients who underwent curative surgery, one patient had no recurrence, and 2 patients proceeded to local or distant recurrences. All the patients are still alive with the mean follow-up period of 23 (R: 3.7-67.1) months.
Conclusion : As the technique of sternal reconstruction develops, the surgical approach can be more aggressively applied to breast cancer patients who are not resolved by chemoradiotherapy.
책임저자: Hee Chul Yang
Department of Thoracic Surgery, National Cancer Center, Goyang, Republic of Korea
발표자: HEE CHUL YANG, E-mail : pda1052@gmail.com