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[Bronchial cancers invading the chest wall].

M Ribet1, G al Nashawati

  • 1Service de Chirurgie de l'Hôpital Calmette, CHRU, Lille.

Revue Des Maladies Respiratoires
|January 1, 1992
PubMed
Summary
This summary is machine-generated.

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Surgical resection of bronchial carcinoma invading the chest wall offers improved survival, though operative mortality is significant. Early detection and surgical intervention are crucial for better patient outcomes in T3 cancers.

Area of Science:

  • Thoracic surgery
  • Surgical oncology
  • Pulmonary medicine

Context:

  • Bronchial carcinoma invading the chest wall presents a complex surgical challenge.
  • Thoracic pain is a common symptom, but not always present, indicating chest wall invasion.
  • Preoperative imaging modalities have limitations in accurately assessing the extent of parietal invasion.

Purpose:

  • To evaluate the outcomes of surgical resection for bronchial carcinoma invading the chest wall.
  • To analyze the role of thoracic pain and imaging in diagnosing chest wall invasion.
  • To assess the surgical prognosis and operative mortality associated with T3 bronchial cancers.

Summary:

  • One hundred and twenty-five patients with bronchial carcinoma invading the chest wall underwent various resections (pneumonectomy, bilobectomy, lobectomy, atypical resection).

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  • Resection was impossible in 10.4% of cases due to anatomical or functional reasons. Parietal invasion was confirmed in a significant proportion of resected and non-resected specimens.
  • Operative mortality was 12.5%, with 5-year survival rates of 11.1%. Median survival was longer for resected patients.
  • Thoracic pain indicated invasion in 87.5% of cases, but 24% of invasions were asymptomatic. Imaging's negative predictive values were feeble.

    • Impact:

    • Surgical chest wall resection for T3 cancers, while not statistically significant in this series, appears to offer better results than non-resection.
    • The study highlights the poorer prognosis of T3 cancers compared to T2 tumors.
    • Findings underscore the need for careful operative assessment and consideration of chest wall resection in fixed tumors with chest wall adhesion.