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Long-term follow-up and quality of life after a thoracic wall resection

C. Klein, E. Aubry, E. Thebaut, R. Besson, M. Bonnevalle

CHRU Lille , France

 

ABSTRACT

Introduction: In childhood, the tumours of the thoracic wall are rare. Their management consists in a resection of the thoracic wall. We were interested in the quality of life of the patients having had this intervention.

Material and methods: It is a retrospective study of the living patients having had a resection of the thoracic wall between January 1995 and December 2006 in the CHRU of Lille and the response to the SF36 questionnaire concerning the quality of life.

Results: Sixteen patients had a carcinological resection of the thoracic wall, 6 died and 10 were to be included: 6 had a Ewing sarcoma, 1 a primitive tumour of neuroectodermic origin, 1 had a rhabdomyosarcoma and 1 had a congenital fibromatosis. Average survival was 62.5% with 6.5 years average fallow-up, only one patient developed a relapse. The average age at surgery was 11 years and 7 months. The median number of the resected ribs was 3. The average body mass index (BMI) was 19.3. None of the patients had school difficulties. Four patients had a deformation of the thoracic wall and 2 complained of aesthetic sequelae, 4 patients had a vertebral deformation. A patient complained about neuropathic pain requiring analgesic treatment by carbamazepine. Seven patients complained of effort dyspnoea and 3 required a treatment by B-2 mimetic. Eight patients answered the SF 36 questionnaire. Concerning the physical activity, the average was 90/100 for an average in the general population of 84.45/100. Concerning the perceived health, the average was 64.5/100 versus 69.3/100 in the general population and concerning physical pain, the average of our group was 77.25/100 versus 73.39/100 in the general population. Concerning psychical health, the average was 79/100 whereas in the general population it was 68.47/100.

Conclusion: The long-term follow-up and the quality of life of the children having had a resection of the thoracic wall are close to the general population what make this heavy surgery licit.

 

Key words: tumours of the thoracic wall, resection of the thoracic wall, Ewing sarcoma, tumour of neuroectodermic origin, rhabdomyosarcoma, congenital fibromatosis