2002 CTOS Annual Meeting Oral Presentations — Surgery

THE ROLE OF ULTRASONOGRAPHY TO EVALUATE CHEST WALL SARCOMAS
[Abstract ID: 39]

Category: Surgery

Presentation: /oral

Authors: Antonio Briccoli¹, Michele Rocca¹, Stefano Galletti², Elio Ricchi³
Author Institutions: ¹Department of General Surgery Rizzoli Orthopaedic Institute Bologna, Italy; ²Department of Ultrasound Imaging Rizzoli Orthopaedic Institute Bologna, Italy; ³General Surgery University of Modena, Italy

Presenter: Antonio Briccoli
antonio.briccoli@ior.it

Correspondent: Antonio Briccoli
antonio.briccoli@ior.it
Bologna Italy 40136
Ph: 390516366222
Fax: 39051331710

Objectives: Surgery is the elective treatment for chest wall sarcoma. Local recurrence, varies from 7% (Pairolero) to 52% (King), and is normally determined by an inadequate surgical exeresis.The goal of this paper is to define a preoperative approach to study tumor margins.

Methods: 19 patients with a chest wall sarcoma were routinely submitted to an Rx, CT, MRI, total body scintigraphy, and US evaluation. US was always performed by the same person with a Siemens Sonoline Omnia, employing a probe 5-13 Mhz, and performing a color-doppler evaluation of the lesion. The scan was done with the patient lying in the surgical position. Tumor lateral margins were identified and a line was marked out at 4 cm (safe oncological margin).

Results: Histologically all the surgical specimen removed following the US margins revealed wide exeresis (Enneking classification). On the contrary CT scan and MRI showed a 27% underestimation and a 18% overestimation respectively of the tumor lateral margins. CT and MRI correctly evaluated in 94% of patients deep margins.US detected one or more micronodules in 4 out of 5 patients with local recurrence. Histologically they were all sarcoma nodules (mean diameter 3 mm).18 patients were disease free at 24 months (4-9). One patient died due to cerebral and bone metastasis.

Conclusions: US sensitivity (100%), specificity (98%), and accuracy (98%) in detecting chest wall involvement of lung cancer is well known since 10 years (Suzuki). Our results confirm the reliability of US also in the study of chest wall sarcomas superficial margins and micronodules.