[Surgical treatment of T3N0M0 non-small cell lung cancer]

From January 1982 to June 1995, 45 patients underwent operation at our department for T3N0M0 non-small cell lung cancer. Tumors invaded chest wall in 38 patients (parietal pleura in 17, subpleural fat tissue in 10, and rib in 11), diaphragm in 3, mediastinum in 3, and pericardium in 1. Extrapleural dissection was performed in 17 patients and en bloc resection of chest wall and lung was performed in 21. Complete resection was possible in 43 patients (96%). Operative mortality was 2.2%. The actuarial overall 5-year survival rate was 63% for the patients with parietal pleura invasion, 45% for those with subpleural invasion, 45% for those with rib invasion, and 56% for those with diaphragm, mediastinal pleura or pericardial invasion. Recurrence at the resected margin was observed in 5 patients with chest wall invasion (subpleural tissue in 3, rib in 2) and 1 with diaphragmatic invasion. In conclusion, we recommend an en bloc resection of the chest wall with enough surgical margin for peripheral tumors firmly adherent to the parietal pleura.