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J Plast Reconstr Aesthet Surg. 2019 May 23. pii: S1748-6815(19)30241-4. doi: 10.1016/j.bjps.2019.05.040. [Epub ahead of print]

Health-related quality of life after oncological resection and reconstruction of the chest wall.

Author information

1
Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: juho.salo@hus.fi.
2
Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Surgery, Central Finland Health Care District, Jyväskylä, Finland.
3
Group Administration, University of Helsinki and Helsinki University Hospital, Finland; Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, University of Eastern Finland, Kuopio, Finland.
4
Department of Public Health, University of Helsinki, Helsinki, Finland.
5
Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Abstract

OBJECTIVES:

There is limited information of the health-related quality of life (HRQoL) after surgical treatment of chest wall tumors. This cross-sectional study aimed to assess long-term HRQoL after chest wall reconstruction following oncological resection.

METHODS:

Seventy-eight patients having undergone chest wall tumor resection and reconstruction during 1997-2015 were invited to complete the 15D and QLQ-C30 HRQoL instruments.

RESULTS:

Altogether, 55 patients (17 men and 38 women), with a mean (SD) age of 68 (14) years, completed the questionnaires (response rate 71%). Patients had been operated due to soft tissue sarcoma (n = 16), advanced breast cancer (n = 15), osteo- or chondrosarcoma (n = 14), or other tumor (n = 10). Median time after primary surgery was 66 (IQR 38, 141) months. The resection was full thickness in 29/55 cases and partial thickness in 26/55 cases. Chest wall reconstruction was required for 47/55 cases (85%). Reconstruction was performed using soft-tissue flap in eight cases, skeletal stabilizations with mesh or mesh-cement-mesh (sandwich method) in 15 cases, and skeletal stabilizations and soft-tissue flap in 24 cases. Patients' mean 15D score (0.878, SD 0.111) was comparable to that of the age- and gender-standardized general population (0.891, SD 0.041). Limitations in breathing and usual activities were noted. The QLQ-C30 cancer-specific HRQoL was 72 points (maximum 100). Scores in the QLQ-C30 Functional scales ranged from 78 (Physical) to 91 (Social).

CONCLUSIONS:

Long-term HRQoL in patients after chest wall reconstruction following oncological resection is fair and comparable to that of the general population. Limitations in breathing and usual activities can occur.

KEYWORDS:

15D; Breast cancer; Chest wall; QLQ-C30; Quality of life; Reconstruction; Resection; Sarcoma

PMID:
31201108
DOI:
10.1016/j.bjps.2019.05.040

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