Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1996 Aug;51(8):846–850. doi: 10.1136/thx.51.8.846

Surgical treatment of 125 patients with non-small cell lung cancer and chest wall involvement.

C C Pitz 1, A Brutel de la Rivière 1, H R Elbers 1, C J Westermann 1, J M van den Bosch 1
PMCID: PMC472570  PMID: 8795676

Abstract

BACKGROUND: The optimum operative procedure for lung cancer with chest wall invasion (T3) remains controversial. In this study results of en bloc resection and extrapleural dissection are reviewed to determine survival characteristics. METHODS: Between 1977 and 1993 125 patients underwent surgery for primary non-small cell lung cancer with chest wall invasion. Patients with superior sulcus tumours, metastatic carcinomas, synchronous tumours, or recurrences were excluded. Extrapleural dissection was performed in 73 patients and en bloc resection (range 1-4 ribs) in 52. Resection was regarded as complete in 86 and incomplete in 39 patients. Actuarial survival time was estimated and risk factors for late death were identified. RESULTS: Hospital mortality was 3.2%. (n = 4). Estimated mean five year survival was 24% for all hospital survivors (n = 121), 11% for patients with incomplete resection, and 29% for patients having a complete resection. In patients who underwent complete resection mediastinal lymph node involvement and intrapleural tumour spill worsened the prognosis. Patients with adenocarcinoma had a better chance of long term survival. No relationship was found between survival and age, type of operative procedure, depth of chest wall invasion, and postoperative radiotherapy. CONCLUSIONS: Both operative procedures show reasonable survival results. Incomplete resection, mediastinal lymph node involvement, and intrapleural tumour spill adversely influence survival.

Full text

PDF
848

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albertucci M., DeMeester T. R., Rothberg M., Hagen J. A., Santoscoy R., Smyrk T. C. Surgery and the management of peripheral lung tumors adherent to the parietal pleura. J Thorac Cardiovasc Surg. 1992 Jan;103(1):8–13. [PubMed] [Google Scholar]
  2. Allen M. S., Mathisen D. J., Grillo H. C., Wain J. C., Moncure A. C., Hilgenberg A. D. Bronchogenic carcinoma with chest wall invasion. Ann Thorac Surg. 1991 Jun;51(6):948–951. doi: 10.1016/0003-4975(91)91011-j. [DOI] [PubMed] [Google Scholar]
  3. Carrel T., Nachbur B., Veraguth P. En bloc resection for bronchogenic carcinoma with chest wall invasion. Value of pre-operative radiotherapy. Eur J Cardiothorac Surg. 1990;4(10):534–537. doi: 10.1016/1010-7940(90)90141-l. [DOI] [PubMed] [Google Scholar]
  4. Casillas M., Paris F., Tarrazona V., Padilla J., Paniagua M., Galan G. Surgical treatment of lung carcinoma involving the chest wall. Eur J Cardiothorac Surg. 1989;3(5):425–429. doi: 10.1016/1010-7940(89)90052-3. [DOI] [PubMed] [Google Scholar]
  5. Coleman F. P. Primary Carcinoma of the Lung, with Invasion of the Ribs: Pneumonectomy and Simultaneous Block Resection of the Chest Wall. Ann Surg. 1947 Aug;126(2):156–168. doi: 10.1097/00000658-194708000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Geha A. S., Bernatz P. E., Woolner L. B. Bronchogenic carcinoma involving the thoracic wall. Surgical treatment and prognostic significance. J Thorac Cardiovasc Surg. 1967 Sep;54(3):394–402. [PubMed] [Google Scholar]
  7. Grillo H. C., Greenberg J. J., Wilkins E. W., Jr Resection of bronchogenic carcinoma involving thoracic wall. J Thorac Cardiovasc Surg. 1966 Mar;51(3):417–421. [PubMed] [Google Scholar]
  8. López L., López Pujol J., Varela A., Baamonde C., Socas L., Salvatierra A., Freixinet J., Cerezo F. Surgical treatment of stage III non-small cell bronchogenic carcinoma involving the chest wall. Scand J Thorac Cardiovasc Surg. 1992;26(2):129–133. doi: 10.3109/14017439209099067. [DOI] [PubMed] [Google Scholar]
  9. McCaughan B. C., Martini N., Bains M. S., McCormack P. M. Chest wall invasion in carcinoma of the lung. Therapeutic and prognostic implications. J Thorac Cardiovasc Surg. 1985 Jun;89(6):836–841. [PubMed] [Google Scholar]
  10. Paone J. F., Spees E. K., Newton C. G., Lillemoe K. D., Kieffer R. F., Gadacz T. R. An appraisal of en bloc resection of peripheral bronchogenic carcinoma involving the thoracic wall. Chest. 1982 Feb;81(2):203–207. doi: 10.1378/chest.81.2.203. [DOI] [PubMed] [Google Scholar]
  11. Patterson G. A., Ilves R., Ginsberg R. J., Cooper J. D., Todd T. R., Pearson F. G. The value of adjuvant radiotherapy in pulmonary and chest wall resection for bronchogenic carcinoma. Ann Thorac Surg. 1982 Dec;34(6):692–697. doi: 10.1016/s0003-4975(10)60911-3. [DOI] [PubMed] [Google Scholar]
  12. Piehler J. M., Pairolero P. C., Weiland L. H., Offord K. P., Payne W. S., Bernatz P. E. Bronchogenic carcinoma with chest wall invasion: factors affecting survival following en bloc resection. Ann Thorac Surg. 1982 Dec;34(6):684–691. doi: 10.1016/s0003-4975(10)60909-5. [DOI] [PubMed] [Google Scholar]
  13. Trastek V. F., Pairolero P. C., Piehler J. M., Weiland L. H., O'Brien P. C., Payne W. S., Bernatz P. E. En bloc (non-chest wall) resection for bronchogenic carcinoma with parietal fixation. Factors affecting survival. J Thorac Cardiovasc Surg. 1984 Mar;87(3):352–358. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES