Abstract
Department of Surgery, Osaka Prefectural Habikino Hospital, Osaka, Japan A retrospective review was performed to evaluate patterns of failure and prognosis of pT3N0M0 patients with resected non-small cell lung cancer involving the chest wall (n=42). Tumor invasion was confined to the parietal pleura in 12 patients (Group A), to the subpleural soft tissue in 24 patients (Group B), and to the rib in 6 patients (Group C). The 5-year survival rates of patients with such invasion were 41.7%, 36.4%, and 33.3 %, respectively. In Group B and C patients, a better prognosis can be expected with adjuvant therapy.
The rates of recurrence (local: distant) of each group were (0: 9), (3: 7), (1: 3), respectively. In patients with involvement of only parietal pleura, the 5-year survival rate of parietal pleurectomy and en bloc chest wall resection was 40.0% and 42.9%, respectively (N. S.). Extrapleural dissection is a valid procedure for patients with only parietal pleura involvement however, an effective and systemic adjuvant therapy should be applied for treatment of lung cancer with chest wall invasion because of its high frequency of distant metastasis.
