The pathologic diagnosis of the SST

The pathologic diagnosis of the SST was as follows: squamous cell carcinoma (n = 12), adenocarcinoma (n = 4), and large-cell undifferentiated carcinoma (n = 5). Three patients entered the protocol without definitive pathologic diagnosis before starting treatment, but the fine-needle aspiration showed malignant cells. In two patients after resection, only necrosis could be found in the surgical specimen; in the third patient, residual squamous-cell carcinoma was present.

Of the 21 patients who underwent a resection, three ribs were resected in 10 patients, four ribs in 6 patients, and five ribs in 2 patients. In 16 patients, a lobectomy was performed, 3 patients underwent bilobectomy, and 4 patients underwent pneumonectomy.

Because in most cases, the chest wall defect was covered by the scapula, in only seven patients (four patients with a large posterior, and all three patients with an anterior defect) a reconstruction was made using an artificial layer was used to obtain chest wall stability.

One patient died 1 week after the operation because of cardiac failure. The postoperative mortality is 1 of 23 patients (4%). Another patient was readmitted in the hospital with a bronchopleural fistula and sepsis, and died 7 weeks after surgery. Two patients had a prolonged hospital stay of > 3 weeks because of ARDS and pleural empyema; both recovered after intensive conservative treatment. In this retrospective analysis, no detailed information was available about functional morbidity and the use of analgesics.

In 21 patients, after a median follow-up of 18 months (range, 5 to 58 months), 8 patients were alive (37%), of which had no evidence of disease (median follow-up, 24 months; range, 6 to 58 months). Thirteen patients died, all but one with metastatic disease (63%). The first site of distant relapse was lung (n = 3), bone (n = 2), brain (n = 2), soft tissue (n = 2), and visceral (n = 2). The median survival after treatment Viagra Proffesional in Canada of SST for this group of patients was 14 months, and the median survival after distant relapse was 6 months (range, 1 to 15 months). At the end of the study, 18 patients (85%) were free from locoregional relapse (median follow-up of 18 months). All five patients who had a local relapse after 8 to 16 months (median, 11 months) underwent a R1 resection (macroscopic radical, but at microscopic examination no tumor-free margins). Two of them had a locoregional recurrence without distant metastases. The median survival of all patients with a relapse was 5 months (range, 1 to 15 months).

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