Value of porous titanium alloy plates for chest wall reconstruction after resection of chest wall tumors

Histopathological features of chest wall masses: a systematic review

Chest wall masses can be caused by trauma, infections, inflammation, or cancer. These tumors can be benign or malignant and originate from different structures of the chest wall. This systematic review aimed to investigate the histopathological characteristics of chest wall masses. The study followed the PRISMA guidelines. PubMed, Scopus, and Web of Science databases were searched for case series that reported the histopathological features of chest wall masses, without any restrictions on the date. The risk of bias was assessed using the JBI critical appraisal tools. Nine studies were included in the final review. Studies included a total of 1,279 patients with chest wall masses, with diverse age ranges. Biopsy methods such as fine-needle aspiration biopsy (FNAB), cutting needle biopsy, and surgical resection biopsy were used to evaluate the pathology of the masses. The rate of malignancy in chest wall masses varied depending on the biopsy method used, ranging from 27.12% in needle biopsy to 47.16% in surgical resection biopsy. The overall rate of malignancy in chest wall tumors was 31.27%. About one-third of the chest wall masses are malignant, emphasizing the importance of accurate diagnosis and appropriate treatment selection. Choosing the proper biopsy method is crucial for achieving successful outcomes and reducing mortality rates. Further research with larger sample sizes and improved reporting is needed to enhance our understanding of chest wall tumor pathology and improve patient outcomes.

Impact of pleural reconstruction on postoperative outcomes in rib tumor resection: a decade-long retrospective study

Objective

This study aims to evaluate the effects of pleural reconstruction during rib compartment tumor resection surgery on postoperative outcomes, including drainage volume, drainage duration, hospital stay, complications, and pain control.

Methods

A retrospective analysis was conducted on 142 patients who underwent rib compartment tumor resection surgery at Beijing Jishuitan Hospital from January 2013 to October 2023. The patients were divided into two groups: those who received pleural reconstruction and those who did not. Data were collected from hospital medical records and outpatient care records, focusing on postoperative drainage volume, total drainage time, length of hospital stay, complications, and pain scores. Continuous variables were compared using t-tests or nonparametric tests, while categorical variables were analyzed using chi-square tests or Fisher's exact tests.

Results

The analysis showed no significant differences between the two groups in terms of postoperative complications and pain thresholds. However, patients who underwent pleural reconstruction had significantly lower postoperative drainage volume (937.74 ± 855.97 vs. 1,595.26 ± 1,054.50 ml, p < 0.05), shorter drainage duration (5.5 ± 2.39 vs. 8.43 ± 2.87 days, p < 0.05), and reduced length of hospital stay (7.32 ± 3.30 vs. 10.99 ± 6.83 days, p < 0.05).

Conclusion

Pleural reconstruction during rib compartment tumor resection surgery reduces postoperative drainage volume, drainage duration, and hospital stay without increasing complications or short-term pain. Further large-scale studies are recommended to validate these findings.

An ascorbic acid-decorated nanostructured surface on titanium inhibits breast cancer development and promotes osteogenesis

The chest wall is the most frequent metastatic site of breast cancer (BC) and the metastasis usually occurs in a solitary setting. Chest wall resection is a way to treat solitary BC metastasis, but intraoperative bone defects and local tumor recurrence still affect the life quality of patients. Titanium-based prostheses are widely used for chest wall repair and reconstruction, but their inherent bio-inertness makes their clinical performance unfavorable. Nanostructured surfaces can give titanium substrates the ability to excellently modulate a variety of cellular functions. Ascorbic acid is a potential stimulator of tumor suppression and osteogenic differentiation. An ascorbic acid-decorated nanostructured titanium surface was prepared through alkali treatment and spin-coating technique and its effects on the biological responses of BC cells and osteoblasts were assessed. The results exhibited that the nanorod structure and ascorbic acid synergistically inhibited the proliferation, spreading, and migration of BC cells. Additionally, the ascorbic acid-decorated nanostructured surface significantly promoted the proliferation and osteogenic differentiation of osteoblasts. This work may provide valuable references for the clinical application of titanium materials in chest wall reconstruction after the resection of metastatic BC.

Electrospun fibers integrating enzyme-functionalized metal-organic frameworks for postoperative tumor recurrence inhibition and simultaneously wound tissue healing

The tumor recurrence and infected wound tissue defect are the major clinical challenges after the surgical treatment of primary chest wall cancer. Herein, to address the above issues, blending electrospinning was applied to incorporate glucose oxidase (GOx) loaded Zn/Cu-based bimetallic zeolitic imidazolate frameworks (GOx/BMOFs) into polyurethane (PU) fibers, which were designed for effective cancer therapy with improved wound healing. The release of Cu2+ and GOx could accomplish the conversion from Cu2+ to Cu+ through the glutathione (GSH) depletion and provide additional H2O2 from glucose by GOx catalysis, respectively, which further underwent the Fenton-like reaction to produce toxic hydroxyl radical (OH). The tumor cells (human fibrosarcoma cells) could be effectively killed in vitro and in vivo through the synergistic chemodynamic therapy and starvation therapy. Moreover, the electrospun fiber platform could support the adhesion and proliferation of wound tissue cells, and also show the antibacterial ability owing to the functional agents in the fibers, thereby accelerating the infected wound repair in vivo. This work may offer a reliable and effective fiber biomaterial for localized chest wall tumor therapy and simultaneous tissue regeneration.

Reconstruction of the chest wall in locally advanced breast cancer with multi-disciplinary cooperation: a case report of mesh repair plus TRAM combined with DIEP chest wall reconstruction

Locally advanced breast cancer, which is defined as a malignant breast tumor that invades or adheres to the surrounding tissue, is characterized by the invasion of the chest wall and the skin surface by the tumor. Multiple lymph nodes are invaded and fuse into a mass, causing extensive axillary lymph node metastasis. However, locally advanced breast cancer does not exhibit distant metastasis. At present, in most hospitals in China and the rest of the world, this type of breast cancer is primarily managed through systematic and local treatments. However, a consensus concerning the optimal surgical method for chest wall reconstruction, which for many surgeons is a difficult and confusing procedure, has not been reached. In the past, many breast centers had used skin flap combined with hard mesh titanium alloy plate to repair the large chest wall defects. Although titanium alloy plate can maintain the stability of the chest wall, it may have a negative effect on the follow-up radiotherapy of breast cancer patients, which is a controversial method. In addition, titanium alloy mesh also has the risk of deformation and fracture. These factors will cause some hidden dangers to patient safety. According to the research, the soft mesh not only has the characteristics of satisfactory compatibility and robustness for maintaining the stability of chest wall, but also does not affect the postoperative radiotherapy of patients. Combined with the advantages of soft mesh, Our department treated a case of locally advanced breast cancer with chest wall invasion. Through cooperation between the breast surgery and thoracic surgery departments, a mesh repair plus transverse rectus abdominis myocutaneous (TRAM) combined with deep inferior epigastric perforator (DIEP) procedure was performed to remove the breast tumor and repair the large area of skin defect after surgery, and a relatively satisfactory therapeutic effect was achieved. In this case, we took two novel approaches: first, a 4-layer high-density polyethylene mesh was used to repair the defect; secondly, the inferior epigastric artery perforation was anastomosed with the thoracoacromial artery (end-to-end anastomosis) and the inferior epigastric vein perforation was anastomosed with the axillary vein (end-to-side anastomosis).

Pinus massoniana bark extract inhibits migration of the lung cancer A549 cell line

The bark of Pinus massoniana is a traditional Chinese medicine for the treatment of various health disorders. Previous studies have demonstrated that P. massoniana bark extract (PMBE) may induce the apoptosis of hepatoma and cervical cancer cells. However, whether PMBE is able to inhibit the migration of lung cancer cells requires further investigation. In the current study, the effects of PMBE on the viability of human lung cancer A549 cells were detected using an MTT assay. The migration of lung cancer cells following exposure to PMBE were quantified using wound healing and Transwell assays, respectively. The expression levels of matrix metalloproteinase (MMP)-9 were determined using western blotting. The results revealed that PMBE significantly inhibited the growth of the lung cancer cells. In addition, the wound closure rate and the migration of the lung cancer cells were suppressed by PMBE. Furthermore, the expression levels of MMP-9 were reduced. These findings indicated that PMBE is able to restrict the migration and invasion of lung cancer cells, and that PMBE may serve as a novel therapeutic agent for patients with metastatic lung cancer in the future.