To study the quality of life and the functional assessment after major chest wall resection.
Retrospective analysis of 50 patients operated on between 1983 tand 2001. The etiologies were bronchogenic carcinoma (pT3), primary parietal tumor and chest wall metastasis from sarscoma in 12, 17 and 18 patients respectively. Median rib resection was 3. We performed a complex reconstruction with prosthetic and/or autologuous material in 28 patients.Beside survival analysis, quality of life of long-term survivors ( > 36 months) was assessed both by the Borg dyspnea scale (0-10) and the OMS performance status score (0-3).The functionnal assessment was calculated using the Mahler index (0-12) as well as the pulmonary function tests (PFT’s) pre and post-operatively.
There was no perioperative mortality. The resection was complete in 42 patients (80%). Overall 3 and 5 years survival were 60 and 57 %, respectively. Among the 26 deaths (52%) registered during follow up, 20 were cancer-related. All the 24 long-term survivors participated in the questionnaire survey. Out of those, 21/24 patients had a score on the Borg scale of 0 to 2 and OMS performance status 0 to 1. Fifteen survivors had a Mahler index between 9 and 12. From the PFT’s studies, we found that the mean reduction of the FEV1 and the VC was respectively 18% and 15%.
Despite extensive chest wall resection, our study shows that with appropriate technique, long term survival and excellent quality of life can be achieved in the most majority of those patients.
Alain Poncelet, None.