Background. Surgical resection of tumors of the cervicothoracic junction is often problematic due to the limitations imposed by the thoracic cage and adjacent neurovascular structures. The majority of surgical approaches to this region have been designed with the intent of providing adequate exposure for vertebrectomy with tumor resection and vertebral column stabilization. Theses approaches do not provide adequate exposure for a heterogeneous group of tumors which also involve the cervicothoracic junction. We used a combined cervicothoracic surgical approach to determine its efficacy in tumor resection.
Method. Seventeen patients with a heterogeneous group of malignancies arising in a variety of soft tissues underwent combined cervicothoracic resection. The approach consisted of anterior cervical access, median sternotomy, and anterior thoracotomy.
Results. Complete gross tumor resection was accomplished in all 17 patients, 15 of whom had negative microscopic margins. Extensive reconstruction was employed in 6 patients. Three patients received intraoperative brachytherapy implants and 5 patients received external-beam postoperative radiotherapy. Local tumor control was obtained in 12 patients, and 10 patients are currently alive, free of disease (median: 12 months; range: 3-47 months). There was no in-From the