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

Details

• Alternative Title:
  Ann Surg
• Personal Author:
  Harris, Courtney J ; Helenowski, Irene ; Murphy, Andrew J ; Mansfield, Sara A ; LaQuaglia, Michael P ; Heaton, Todd E ; Cavalli, Michele ; Murphy, Joseph T ; Newman, Erika ; Overmen, Richard E ; Kartal, Tanvi T ; Cooke-Barber, Jo ; Donaher, Addison ; Malek, Marcus M ; Kalsi, Ranjeet ; Kim, Eugene S ; Zobel, Michael J ; Goodhue, Catherine J ; Naik-Mathuria, Bindi J ; Jefferson, Imory N ; Roach, Jonathan P ; Mata, Claudia ; Piché, Nelson ; Joharifard, Shahrzad ; Sultan, Serge ; Short, Scott S ; Meyers, Rebecka L ; Bleicher, Josh ; Le, Hau D ; Janek, Kevin ; Bütter, Andreana ; Davidson, Jacob ; Aldrink, Jennifer H ; Richards, Holden W ; Tracy, Elisabeth T ; Commander, Sarah J ; Fialkowski, Elizabeth A ; Troutt, Misty ; Dasgupta, Roshni ; Lautz, Timothy B
• Description:
  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 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 2008–2017 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 (IQR=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 posterior rib 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 following 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.
  
  
• Subjects:
  Adolescent Child Humans Quality Of Life Retrospective Studies Sarcoma Scoliosis Surgical Oncology Thoracic Neoplasms Thoracic Wall
• Source:
  Ann Surg. 276(6):e969-e975
• Pubmed ID:
  33156070
• Pubmed Central ID:
  PMC8093319
• Document Type:
  Journal Article
• Funding:
  P30 CA008748/CA/NCI NIH HHSUnited States/ ; R01 CE003247/CE/NCIPC CDC HHSUnited States/ ; T32 AI125231/AI/NIAID NIH HHSUnited States/
• Volume:
  276
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:7cd888bbf79d32527fd5192ac2c611f2cd2de2b4e5097950c0ca0704adf3facea100935fb303d6f56aa93bad4de04ba3649ab49dacf5de7435217f68c0cbf488
• Download URL:
  https://stacks.cdc.gov/view/cdc/124412/cdc_124412_DS1.pdf
• File Type:
  [PDF - 379.38 KB ]