Mid-Term Outcomes of Titanium Plate Reconstruction for Lung Cancer Requiring Chest Wall Resection

Chest wall resection for non-small cell lung cancer (NSCLC) with chest wall invasion is rare and technically demanding, requiring complete resection and durable reconstruction. Although titanium-based devices are increasingly used, NSCLC-specific outcome data remain limited. We evaluated short- and mid-term outcomes of titanium plate-based chest wall reconstruction in NSCLC.

We retrospectively reviewed 16 consecutive patients who underwent en bloc pulmonary and chest wall resection with titanium plate reconstruction for NSCLC between 2013 and 2019. Indications included resection of ≥3 ribs or anticipated instability. Reconstruction used perforated titanium plates tailored to defect geometry. Postoperative complications, late reconstruction-related events, and oncologic outcomes were analysed.

Preoperative therapy was administered in 8 patients (50%), including chemoradiotherapy in 7. R0 resection was achieved in 94%. Defects were predominantly posterior, with reconstruction adjacent to the scapula in 12 patients (75%). Thirty-day postoperative complications occurred in 9 patients (56%), consisting predominantly of pulmonary events. Postoperative chemotherapy was given to 6 patients (38%). During a median follow-up of 24 months (mean 54 months), 2 late complications occurred: chest wall haematoma and empyema. Only 1 chest wall local recurrence was observed. No structural failure or scapular impingement occurred. Five-year recurrence-free and overall survival rates were 35% and 63%, respectively.

Titanium plate-based chest wall reconstruction enables extensive en bloc resection for NSCLC with chest wall invasion while maintaining mid-term structural stability. With appropriate patient selection and follow-up, this technique provides acceptable mid-term outcomes with durable structural stability.