Long-Term Outcome and Prognostic Factors After Chest Wall Resection and Reconstruction

This retrospective single-center study analyzed 143 patients who underwent chest wall resection and reconstruction from 2010–2023. Among these, 55.2 percent had lung cancer invading the chest wall, predominantly adenocarcinoma and squamous cell carcinoma. Rib resection alone was performed in 69.9 percent of cases, with reconstruction utilizing synthetic, metallic, or combined materials, often alongside muscle or myocutaneous flaps. R0 resection was achieved in 85.9 percent of cases. The median tumor size was 10 cm. Perioperative complications occurred in 25.7 percent, associated with factors such as age, sternal resection, and longer surgery duration. Neuropathic pain was more frequent after posterolateral thoracotomy. The median disease-free survival was 36 months, and the median overall survival was 80 months, with a five-year overall survival of 74.1 percent. The type of reconstruction did not affect survival or the incidence of complications. Reduced survival was linked to older age, squamous histology, larger resections, postoperative complications, and poor postoperative performance status.