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Bronchogenic carcinoma with chest wall invasion
M S Allen1, D J Mathisen, H C Grillo
1Department of Thoracic Surgery, Massachusetts General Hospital, Boston 02114.
The Annals of Thoracic Surgery
|June 1, 1991
Summary
Bronchogenic carcinoma invading the chest wall is challenging but potentially curable if lymph nodes are not involved. Surgical treatment offers a 26.3% 5-year survival, with lower rates for N1 disease.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Bronchogenic carcinoma with chest wall involvement presents a significant clinical challenge.
- Surgical management is often complex, requiring careful consideration of tumor extent and patient factors.
Purpose of the Study:
- To evaluate the outcomes of surgical treatment for bronchogenic carcinoma with chest wall invasion.
- To assess survival rates, morbidity, and the role of adjuvant therapies.
Main Methods:
- Retrospective analysis of 52 patients treated for bronchogenic carcinoma with chest wall involvement (excluding superior sulcus tumors) since 1973.
- Data collected included patient demographics, presenting symptoms, tumor histology, surgical procedures, pathologic staging, and outcomes.
Main Results:
- The majority of patients had squamous cell carcinoma (53%) or adenocarcinoma (35%).
- Pathologic staging was predominantly T3 N0 M0 (83%).
- The overall 5-year survival rate was 26.3%, significantly lower (11%) for patients with N1 disease. Operative mortality was 3.8%.
Conclusions:
- Bronchogenic carcinoma with chest wall invasion is potentially curable with surgery, particularly when N2 lymph nodes are not involved.
- Adjuvant radiation therapy was used in 46% of cases, but its role requires further definition.
- Minimizing morbidity and mortality is achievable with appropriate surgical management.