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Chest wall resection for bronchogenic carcinoma.

H J van de Wal, L K Lacquet, C M Jongerius

    The Thoracic and Cardiovascular Surgeon
    |June 1, 1984
    PubMed
    Summary

    Surgical resection of bronchogenic carcinoma invading the chest wall can relieve pain. Survival rates are better when lymph nodes are not involved, indicating chest wall resection is a viable option for selected lung cancer patients.

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    Area of Science:

    • Thoracic Surgery
    • Surgical Oncology
    • Pulmonary Medicine

    Background:

    • Chest wall invasion by bronchogenic carcinoma (lung cancer) is uncommon but can lead to locally advanced disease.
    • Surgical intervention offers a potential treatment option for these challenging cases.

    Purpose of the Study:

    • To evaluate the outcomes of en bloc pulmonary and partial chest wall resection for lung cancer with thoracic wall invasion.
    • To assess the impact of lymph node status on survival following this surgical procedure.

    Main Methods:

    • A retrospective review of 9 male patients (ages 49-67) who underwent en bloc resection for lung cancer invading the chest wall between 1973 and 1982.
    • Procedures included lobectomies and pneumonectomies with partial rib resection.
    • Tumor characteristics and postoperative staging (T3N0M0, T3N1M0) were analyzed.

    Main Results:

    • Pain was the most common symptom. Squamous cell carcinoma was the predominant histology (8/9 cases).
    • Two of six patients (T3N0M0) survived over 5 years; neither patient with lymph node involvement (T3N1M0) survived beyond 3 months.
    • Postoperative mortality was 11% (1/9), with late deaths due to recurrence, metastasis, or other causes.

    Conclusions:

    • En bloc pulmonary and partial chest wall resection is a feasible treatment for locally advanced lung cancer invading the thoracic wall.
    • Survival is significantly influenced by lymph node involvement, with better outcomes in node-negative patients.
    • Resection can be crucial for pain palliation in these patients.

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