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The Effect of Histopathological Subtype on 5 Year and 10 Year Overall Survival in Primary Malign Tumors of the Chest Wall

Yıl 2023, Cilt: 10 Sayı: 3, 160 - 170, 19.12.2023
https://doi.org/10.47572/muskutd.1311039

Öz

Primary tumors of the chest wall are rare tumors comprising 5% of thoracic neoplasms. The current study was designed to evaluate the effect of histopathological subtype on the 5-year and 10-year overall survival and regional recurrence in primary malignant tumors of the chest wall. From December 2007 to December 2019, the data of 20 patients were analyzed. Overall survival rates, median overall survival, regional tumor recurrence and median disease-free survival rates were compared retrospectively between histopathological subtypes. Chondrosarcoma (n=7), desmoid tumor (n=6), undifferentiated pleomorphic sarcoma [(UPS), (n=4)], Ewing's sarcoma (n=1), malignant peripheral nerve sheath tumor (n=1), and liposarcoma (n=1) were the subtypes identified. A lower median overall survival was detected in the UPS histopathological subtype (p = 0.004). The 5 and 10-year overall survival rates in the chondrosarcoma group were 71% and 37%, respectively; desmoid tumors were found in 83% and 42%, respectively. There was no patient with 5-year survival in UPS. A shorter median overall survival was found in lateral wall masses compared to anterior and posterior wall masses (p = 0.001). During the follow-up, 10 patients (50%) died. It was observed that the median disease-free survival in the UPS subtype was shorter compared to the other subtypes (p = 0.002). The regional recurrence rate was 57%, 17% and 75% in chondrosarcoma, desmoid tumor and UPS, respectively. In UPS, a primary malignant tumor of the chest wall, 5-year and 10-year overall survival rates and median overall survival; it was found to be significantly shorter than the chondrosarcoma and desmoid tumor groups.

Kaynakça

  • 1. Smith SE, Keshavjee S. Primary chest wall tumors. Thorac Surg Clin. 2010;20(4):495-507.
  • 2. Demirkaya A. Göğüs duvarı primer ve malign tümörleri. Türkiye Klinikleri J Thor Surg-Special Topics. 2018;9(1):123-30.
  • 3. Cipriano A, Burfeind W Jr. Management of primary soft tissue tumors of the chest wall. Thorac Surg Clin. 2017;27:139–47.
  • 4. Pairolero PC. Chest wall tumors. In: Shields TW, LoCicero J, Ponn RB, eds. General Thoracic Surgery. Philadelphia: Lippincott Williams&Wilkins, 2000: 589-608.
  • 5. Somers J, Faber LP. Chondroma and chondrosarcoma. Semin Thorac Cardiovasc Surg. 1999;11:270–7.
  • 6. Shah AA, D’Amico TA. Primary chest wall tumors. J Am Coll Surg. 2010;210(3):360–6.
  • 7. Widhe B, Bauer HC. Surgical treatment is decisive for outcome in chondrosarcoma of the chest wall: a population-based Scandinavian Sarcoma Group study of 106 patients. J Thorac Cardiovasc Surg. 2009;137(3):610–4.
  • 8. Marulli G, Duranti L, Cardillo G, et al. Primary chest wall chondrosarcomas: results of surgical resection and analysis of prognostic factors. Eur J Cardiothorac Surg. 2014;45(6):e194-201.
  • 9. Burt M, Fulton M, Wessner-Dunlap S, et al. Primary bony and cartilaginous sarcomas of chest wall: results of therapy. Ann Thorac Surg. 1992;54:226–32.
  • 10. McAfee MK, Pairolero PC, Bergstralh EJ, et al. Chondrosarcoma of the chest wall: factors affecting survival. Ann Thorac Surg. 1985;40(6):535–41.
  • 11. Gonfiotti A, Santini PF, Campanacci D, et al. Malignant primary chest-wall tumours: techniques of reconstruction and survival. Eur J Cardiothorac Surg. 2010;38(1):39–45.
  • 12. Bielack SS, Carrle D, Hardes J, et al. Bone tumors in adolescents and young adults. Curr Treat Options Oncol. 2008;9(1):67–80.
  • 13. Oğuzkaya F, Hasdıraz L. Göğüs duvarı tümörleri. Ökten İ, Kavukçu HŞ, editör. Göğüs Cerrahisi. 2. Baskı. İstanbul: İstanbul Tıp Kitabevi: 2013.p.1455-1461.
  • 14. Shamberger RC, Laquaglia MP, Gebhardt MC, et al. Ewing sarcoma/primitive neuroectodermal tumor of the chest wall: impact of initial versus delayed resection on tumor margins, survival, and use of radiation therapy. Ann Surg. 2003;238:563–8.
  • 15. Denbo JW, Shannon Orr W, Wu Y, et al. Timing of surgery and the role of adjuvant radiotherapy in Ewing sarcoma of the chest wall: a single-institution experience. Ann Surg Oncol. 2012;19(12):3809–15.
  • 16. Wu C, Amini-Nik S, Nadesan P, et al. Aggressive fibromatosis (desmoid tumor) is derived from mesenchymal progenitor cells. Cancer Res. 2010;70:7690–8.
  • 17. Abbas AE, Deschamps C, Cassivi SD, et al. Chest-wall desmoid tumors: results of surgical intervention. Ann Thorac Surg. 2004;78(4):1219-23.
  • 18. Bolke E, Krasniqi H, Lammering G, et al. Chest wall and intrathoracic desmoid tumors: surgical experience and review of the literature. Eur J Med Res. 2009;14:240–3.
  • 19. Bonvalot S, Eldweny H, Haddad V, et al. Extra-abdominal primary fibromatosis: Aggressive management could be avoided in a subgroup of patients. Eur J Surg Oncol. 2008;34:462–8.
  • 20. Dufresne A, Bertucci F, Penel N, et al. Identification of biological factors predictive of response to imatinib mesylate in aggressive fibromatosis. Br J Cancer. 2010;103:482–5.
  • 21. Fletcher CDM, Bridge JA, Hogendoorn PCW, et al. WHO classification of tumours of soft tissue and bone. Lyon: IARC Press, 2013.
  • 22. Yoshida N, Miyanari N, Yamamoto Y, et al. Successful treatment of malignant fibrous histiocytoma originating in the chest wall: report of a case. Surg Today. 2006;36(8):714–21.
  • 23. Gallo AE. The Johns Hopkins manual of cardiothoracic surgery. New York: McGraw-Hill; 2007.
  • 24. Hayes-Jordan A, Stoner JA, Anderson JR, et al. The impact of surgical excision in chest wall rhabdomyosarcoma: a report from the Children’s Oncology Group. J Pediatr Surg. 2008;43:831–6.
  • 25. Wittekind C, Compton CC, Greene FL, et al. TNM residual tumor classification revisited. Cancer. 2002;94:2511-6.
  • 26. Abdel Rahman ARM, Rahouma M, Gaafar R, et al. Contributing factors to the outcome of primary malignant chest wall tumors. J Thorac Dis. 2017;9(12):5184–93.
  • 27. Yoon SH, Jung JC, Park IK, et al. Clinical outcomes of surgical treatment for primary chest wall soft tissue sarcoma. Korean J Thorac Cardiovasc Surg. 2019;52(3):148-54.
  • 28. Harati K, Kolbenschlag J, Bohm J, et al. Long‐term outcomes of patients with soft tissue sarcoma of the chest wall: analysis of the prognostic significance of microscopic margins. Oncol Lett. 2018;15(2):2179-87.
  • 29. Shewale JB, Mitchell KG, Nelson DB, et al. Predictors of survival after resection of primary sarcomas of the chest wall-A large, single-institution series. J Surg Oncol. 2018;118(3):518-24.
  • 30. Singer S, Corson JM, Demetri GD, et al. Prognostic factors sarcoma. Ann Surg. 1995;221:185–95.
  • 31. Ito T, Suzuki H, Yoshino I. Mini review: surgical management of primary chest wall tumors. Gen Thorac Cardiovasc Surg. 2016;64(12):707-14.
  • 32. King RM, Pairolero PC, Trastek VF, et al. Primary chest wall tumors: factors affecting survival. Ann Thorac Surg. 1986;41:597-601.
  • 33. Friesenbichler J, Leithner A, Maurer-Ertl W, et al. Surgical therapy of primary malignant bone tumors and soft tissue sarcomas of the chest wall: a two-institutional experience. Int Orthop. 2014;38:1235–40.
  • 34. van Geel AN, Wouters MW, Lans TE, et al. Chest wall resection for adult soft tissue sarcomas and chondrosarcomas: analysis of prognostic factors. World J Surg. 2011;35(1):63–9.
  • 35. Hamza A, Alrajjal A, Edens J, et al. Utility of additional tissue sections in surgical pathology. Int J Surg Pathol. 2018;26(5):392-401.
  • 36. Hornick JL. Practical soft tissue pathology: a diagnostic approach, 2nd ed. Philadelphia: Elsevier, 2019.
  • 37. Bagheri R, Haghi SZ, Kalantari MR, et al. Primary malignant chest wall tumors: analysis of 40 patients. J Cardiothorac Surg. 2014;9:106.
  • 38. Sawai H, Kamiya A, Kurahashi S, et al. Malignant fibrous histiocytoma originating from the chest wall: report of a case and collective review of cases. Surg Today. 1998;28:459-63.
  • 39. Kuwahara H, Salo J, Nevala R, et al. Single-institution, multidisciplinary experience of soft tissue sarcomas in the chest wall. Ann Plast Surg. 2019;83(1):82-8.
  • 40. Shah AC, Komperda KW, Mavanur AA, et al. Overall survival and tumor recurrence after surgical resection for primary malignant chest wall tumors: a single-center, single-surgeon experience. J Orthop Surg (Hong Kong). 2019;27(2):2309499019838296.

Göğüs Duvarının Primer Malign Tümörlerinde Histopatolojik Alt Tipin 5 Yıllık ve 10 Yıllık Genel Sağkalıma Etkisi

Yıl 2023, Cilt: 10 Sayı: 3, 160 - 170, 19.12.2023
https://doi.org/10.47572/muskutd.1311039

Öz

Göğüs duvarının primer tümörleri, torasik neoplazmların %5'ini oluşturan nadir tümörlerdir. Mevcut çalışma, göğüs duvarının primer malign tümörlerinde histopatolojik alt tipin 5 yıllık ve 10 yıllık genel sağkalıma ve bölgesel nüks durumlarına etkisini değerlendirmeye yönelik tasarlanmıştır. Aralık 2007’den Aralık 2019’a kadar, 20 hastanın verileri geriye dönük olarak incelendi. Histopatolojik alt tipler arasında; genel sağkalım oranları, ortanca sağkalım, bölgesel tümör nüksü saptanma oranları ve ortanca hastalıksız sağkalım geriye dönük olarak kıyaslandı. Kondrosarkom (n=7), desmoid tümör (n=6), indiferansiye pleomorfik sarkom [(İPS), (n=4)], Ewing sarkomu (n=1), malign periferik sinir kılıf tümörü (n=1) ve liposarkom (n=1) tespit edilen alt tiplerdi. İPS histopatolojik alt tipinde daha düşük ortanca sağkalım tespit edildi (p = 0.004). Kondrosarkom grubunda 5 ve 10 yıllık genel sağkalım oranları sırasıyla, %71 ve %37; desmoid tümörlerde sırasıyla, %83 ve %42 saptandı. İPS’de ise 5 yıllık sağkalım gösteren hasta olmadı. Yan duvar yerleşimli kitlelerde, ön ve arka duvar yerleşimli kitlelere kıyasla daha kısa ortanca sağkalım tespit edildi (p = 0.001). Takip süresince 10 hasta (%50) hayatını kaybetti. İPS alt tipinde ortanca hastalıksız sağkalımın, diğer alt tiplere kıyasla daha kısa olduğu görüldü (p = 0.002). Bölgesel nüks oranları, kondrosarkom, desmoid tümör ve İPS için sırasıyla, %57; %17 ve %75 olarak saptandı. Göğüs duvarının primer malign tümörlerinden İPS’de, 5 yıllık ve 10 yıllık genel sağkalım oranlarının ve ortanca sağkalımın; kondrosarkom ve desmoid tümör gruplarına kıyasla anlamlı ölçüde daha kısa olduğu saptandı.

Kaynakça

  • 1. Smith SE, Keshavjee S. Primary chest wall tumors. Thorac Surg Clin. 2010;20(4):495-507.
  • 2. Demirkaya A. Göğüs duvarı primer ve malign tümörleri. Türkiye Klinikleri J Thor Surg-Special Topics. 2018;9(1):123-30.
  • 3. Cipriano A, Burfeind W Jr. Management of primary soft tissue tumors of the chest wall. Thorac Surg Clin. 2017;27:139–47.
  • 4. Pairolero PC. Chest wall tumors. In: Shields TW, LoCicero J, Ponn RB, eds. General Thoracic Surgery. Philadelphia: Lippincott Williams&Wilkins, 2000: 589-608.
  • 5. Somers J, Faber LP. Chondroma and chondrosarcoma. Semin Thorac Cardiovasc Surg. 1999;11:270–7.
  • 6. Shah AA, D’Amico TA. Primary chest wall tumors. J Am Coll Surg. 2010;210(3):360–6.
  • 7. Widhe B, Bauer HC. Surgical treatment is decisive for outcome in chondrosarcoma of the chest wall: a population-based Scandinavian Sarcoma Group study of 106 patients. J Thorac Cardiovasc Surg. 2009;137(3):610–4.
  • 8. Marulli G, Duranti L, Cardillo G, et al. Primary chest wall chondrosarcomas: results of surgical resection and analysis of prognostic factors. Eur J Cardiothorac Surg. 2014;45(6):e194-201.
  • 9. Burt M, Fulton M, Wessner-Dunlap S, et al. Primary bony and cartilaginous sarcomas of chest wall: results of therapy. Ann Thorac Surg. 1992;54:226–32.
  • 10. McAfee MK, Pairolero PC, Bergstralh EJ, et al. Chondrosarcoma of the chest wall: factors affecting survival. Ann Thorac Surg. 1985;40(6):535–41.
  • 11. Gonfiotti A, Santini PF, Campanacci D, et al. Malignant primary chest-wall tumours: techniques of reconstruction and survival. Eur J Cardiothorac Surg. 2010;38(1):39–45.
  • 12. Bielack SS, Carrle D, Hardes J, et al. Bone tumors in adolescents and young adults. Curr Treat Options Oncol. 2008;9(1):67–80.
  • 13. Oğuzkaya F, Hasdıraz L. Göğüs duvarı tümörleri. Ökten İ, Kavukçu HŞ, editör. Göğüs Cerrahisi. 2. Baskı. İstanbul: İstanbul Tıp Kitabevi: 2013.p.1455-1461.
  • 14. Shamberger RC, Laquaglia MP, Gebhardt MC, et al. Ewing sarcoma/primitive neuroectodermal tumor of the chest wall: impact of initial versus delayed resection on tumor margins, survival, and use of radiation therapy. Ann Surg. 2003;238:563–8.
  • 15. Denbo JW, Shannon Orr W, Wu Y, et al. Timing of surgery and the role of adjuvant radiotherapy in Ewing sarcoma of the chest wall: a single-institution experience. Ann Surg Oncol. 2012;19(12):3809–15.
  • 16. Wu C, Amini-Nik S, Nadesan P, et al. Aggressive fibromatosis (desmoid tumor) is derived from mesenchymal progenitor cells. Cancer Res. 2010;70:7690–8.
  • 17. Abbas AE, Deschamps C, Cassivi SD, et al. Chest-wall desmoid tumors: results of surgical intervention. Ann Thorac Surg. 2004;78(4):1219-23.
  • 18. Bolke E, Krasniqi H, Lammering G, et al. Chest wall and intrathoracic desmoid tumors: surgical experience and review of the literature. Eur J Med Res. 2009;14:240–3.
  • 19. Bonvalot S, Eldweny H, Haddad V, et al. Extra-abdominal primary fibromatosis: Aggressive management could be avoided in a subgroup of patients. Eur J Surg Oncol. 2008;34:462–8.
  • 20. Dufresne A, Bertucci F, Penel N, et al. Identification of biological factors predictive of response to imatinib mesylate in aggressive fibromatosis. Br J Cancer. 2010;103:482–5.
  • 21. Fletcher CDM, Bridge JA, Hogendoorn PCW, et al. WHO classification of tumours of soft tissue and bone. Lyon: IARC Press, 2013.
  • 22. Yoshida N, Miyanari N, Yamamoto Y, et al. Successful treatment of malignant fibrous histiocytoma originating in the chest wall: report of a case. Surg Today. 2006;36(8):714–21.
  • 23. Gallo AE. The Johns Hopkins manual of cardiothoracic surgery. New York: McGraw-Hill; 2007.
  • 24. Hayes-Jordan A, Stoner JA, Anderson JR, et al. The impact of surgical excision in chest wall rhabdomyosarcoma: a report from the Children’s Oncology Group. J Pediatr Surg. 2008;43:831–6.
  • 25. Wittekind C, Compton CC, Greene FL, et al. TNM residual tumor classification revisited. Cancer. 2002;94:2511-6.
  • 26. Abdel Rahman ARM, Rahouma M, Gaafar R, et al. Contributing factors to the outcome of primary malignant chest wall tumors. J Thorac Dis. 2017;9(12):5184–93.
  • 27. Yoon SH, Jung JC, Park IK, et al. Clinical outcomes of surgical treatment for primary chest wall soft tissue sarcoma. Korean J Thorac Cardiovasc Surg. 2019;52(3):148-54.
  • 28. Harati K, Kolbenschlag J, Bohm J, et al. Long‐term outcomes of patients with soft tissue sarcoma of the chest wall: analysis of the prognostic significance of microscopic margins. Oncol Lett. 2018;15(2):2179-87.
  • 29. Shewale JB, Mitchell KG, Nelson DB, et al. Predictors of survival after resection of primary sarcomas of the chest wall-A large, single-institution series. J Surg Oncol. 2018;118(3):518-24.
  • 30. Singer S, Corson JM, Demetri GD, et al. Prognostic factors sarcoma. Ann Surg. 1995;221:185–95.
  • 31. Ito T, Suzuki H, Yoshino I. Mini review: surgical management of primary chest wall tumors. Gen Thorac Cardiovasc Surg. 2016;64(12):707-14.
  • 32. King RM, Pairolero PC, Trastek VF, et al. Primary chest wall tumors: factors affecting survival. Ann Thorac Surg. 1986;41:597-601.
  • 33. Friesenbichler J, Leithner A, Maurer-Ertl W, et al. Surgical therapy of primary malignant bone tumors and soft tissue sarcomas of the chest wall: a two-institutional experience. Int Orthop. 2014;38:1235–40.
  • 34. van Geel AN, Wouters MW, Lans TE, et al. Chest wall resection for adult soft tissue sarcomas and chondrosarcomas: analysis of prognostic factors. World J Surg. 2011;35(1):63–9.
  • 35. Hamza A, Alrajjal A, Edens J, et al. Utility of additional tissue sections in surgical pathology. Int J Surg Pathol. 2018;26(5):392-401.
  • 36. Hornick JL. Practical soft tissue pathology: a diagnostic approach, 2nd ed. Philadelphia: Elsevier, 2019.
  • 37. Bagheri R, Haghi SZ, Kalantari MR, et al. Primary malignant chest wall tumors: analysis of 40 patients. J Cardiothorac Surg. 2014;9:106.
  • 38. Sawai H, Kamiya A, Kurahashi S, et al. Malignant fibrous histiocytoma originating from the chest wall: report of a case and collective review of cases. Surg Today. 1998;28:459-63.
  • 39. Kuwahara H, Salo J, Nevala R, et al. Single-institution, multidisciplinary experience of soft tissue sarcomas in the chest wall. Ann Plast Surg. 2019;83(1):82-8.
  • 40. Shah AC, Komperda KW, Mavanur AA, et al. Overall survival and tumor recurrence after surgical resection for primary malignant chest wall tumors: a single-center, single-surgeon experience. J Orthop Surg (Hong Kong). 2019;27(2):2309499019838296.
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Burak Odabaşı 0000-0002-9469-380X

Mehmet Yıldırım Bu kişi benim 0000-0003-4147-4053

İsmail Dal 0000-0002-5118-0780

M. Didem Aydemir Bu kişi benim 0000-0003-1028-0600

Kemal Demircan Bu kişi benim 0000-0002-0028-3798

Deniz Ezgi Mahmutoğlu 0000-0001-9630-8760

Seçkin Deniz Bu kişi benim 0000-0001-5637-0973

Semih Buluklu Bu kişi benim 0000-0002-1153-7036

Aybiyçe E. Silpağar Bu kişi benim 0000-0002-9274-7982

Murat Yaşaroğlu Bu kişi benim 0000-0001-9791-9387

Bülent Aydemir Bu kişi benim 0000-0001-7073-5131

Tamer Okay Bu kişi benim 0000-0002-3058-3708

Yayımlanma Tarihi 19 Aralık 2023
Gönderilme Tarihi 7 Haziran 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 10 Sayı: 3

Kaynak Göster

APA Odabaşı, B., Yıldırım, M., Dal, İ., Aydemir, M. D., vd. (2023). The Effect of Histopathological Subtype on 5 Year and 10 Year Overall Survival in Primary Malign Tumors of the Chest Wall. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 10(3), 160-170. https://doi.org/10.47572/muskutd.1311039
AMA Odabaşı B, Yıldırım M, Dal İ, Aydemir MD, Demircan K, Mahmutoğlu DE, Deniz S, Buluklu S, Silpağar AE, Yaşaroğlu M, Aydemir B, Okay T. The Effect of Histopathological Subtype on 5 Year and 10 Year Overall Survival in Primary Malign Tumors of the Chest Wall. MMJ. Aralık 2023;10(3):160-170. doi:10.47572/muskutd.1311039
Chicago Odabaşı, Burak, Mehmet Yıldırım, İsmail Dal, M. Didem Aydemir, Kemal Demircan, Deniz Ezgi Mahmutoğlu, Seçkin Deniz, Semih Buluklu, Aybiyçe E. Silpağar, Murat Yaşaroğlu, Bülent Aydemir, ve Tamer Okay. “The Effect of Histopathological Subtype on 5 Year and 10 Year Overall Survival in Primary Malign Tumors of the Chest Wall”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10, sy. 3 (Aralık 2023): 160-70. https://doi.org/10.47572/muskutd.1311039.
EndNote Odabaşı B, Yıldırım M, Dal İ, Aydemir MD, Demircan K, Mahmutoğlu DE, Deniz S, Buluklu S, Silpağar AE, Yaşaroğlu M, Aydemir B, Okay T (01 Aralık 2023) The Effect of Histopathological Subtype on 5 Year and 10 Year Overall Survival in Primary Malign Tumors of the Chest Wall. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10 3 160–170.
IEEE B. Odabaşı, “The Effect of Histopathological Subtype on 5 Year and 10 Year Overall Survival in Primary Malign Tumors of the Chest Wall”, MMJ, c. 10, sy. 3, ss. 160–170, 2023, doi: 10.47572/muskutd.1311039.
ISNAD Odabaşı, Burak vd. “The Effect of Histopathological Subtype on 5 Year and 10 Year Overall Survival in Primary Malign Tumors of the Chest Wall”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10/3 (Aralık 2023), 160-170. https://doi.org/10.47572/muskutd.1311039.
JAMA Odabaşı B, Yıldırım M, Dal İ, Aydemir MD, Demircan K, Mahmutoğlu DE, Deniz S, Buluklu S, Silpağar AE, Yaşaroğlu M, Aydemir B, Okay T. The Effect of Histopathological Subtype on 5 Year and 10 Year Overall Survival in Primary Malign Tumors of the Chest Wall. MMJ. 2023;10:160–170.
MLA Odabaşı, Burak vd. “The Effect of Histopathological Subtype on 5 Year and 10 Year Overall Survival in Primary Malign Tumors of the Chest Wall”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, c. 10, sy. 3, 2023, ss. 160-7, doi:10.47572/muskutd.1311039.
Vancouver Odabaşı B, Yıldırım M, Dal İ, Aydemir MD, Demircan K, Mahmutoğlu DE, Deniz S, Buluklu S, Silpağar AE, Yaşaroğlu M, Aydemir B, Okay T. The Effect of Histopathological Subtype on 5 Year and 10 Year Overall Survival in Primary Malign Tumors of the Chest Wall. MMJ. 2023;10(3):160-7.