Indian Journal of Surgery

, Volume 76, Issue 5, pp 354–358 | Cite as

Clinical Characteristics of Resected T3 Non-small Cell Lung Cancer Characterized by Parietal Pleural Invasion or Chest Wall Invasion

  • Takeshi Hanagiri
  • Shinji Shinohara
  • Masaru Takenaka
  • Hidehiko Shimokawa
  • Yoshika Nagata
  • Makoto Nakagawa
  • Hidetaka Uramoto
  • Tomoko So
  • Fumihiro Tanaka
Original Article
First Online:
Received:
Accepted:

Abstract

This study investigated the clinicopathological characteristics and the surgical outcome in patients with non-small cell carcinoma (NSCLC) with parietal pleura invasion or chest wall invasion (p3/T3). This study clinicopathologically evaluated 760 patients who had undergone a resection for NSCLC between 1999 and 2008. There were 43 (5.7 %) patients with p3/T3 NSCLC. The patients included 37 males and 6 females. The histological types included 23 squamous cell carcinomas, 13 adenocarcinomas, 3 large cell carcinomas, 3 pleomorphic carcinomas, and 1 spindle cell carcinoma. Pneumonectomy was performed in 2 patients, bilobectomy in 1, lobectomy in 31, segmentectomy in 3, and partial resection of the lung in 6. The combined resection regions were parietal pleural in 23, ribs in 16, pericardium in 2, and diaphragm in 2 patients. Major complications included empyema in 1, chylothorax in 1, and postoperative bleeding in 1 patient. The first recurrence sites in 16 patients with recurrent disease were the lung in 5 patients, brain in 3, bone in 2, adrenal gland in 2, skin in 2, liver in 1, mesenterium in 1, mediastinal lymph node in 1, axillary lymph node in 1, and carcinomatous pleuritis in 1. The overall 5-year survival rate after surgery was 50.6 %. An en bloc resection for p3/T3 NSCLC provides a modestly favorable prognosis. Local recurrence was observed in a minority of case, and recurrence by distant metastasis was observed in most cases, suggesting a greater need for postoperative chemotherapy.

Keywords

Parietal pleural invasion Chest wall invasion Surgical resection Non-small cell lung cancer Surgical outcome 
This is a preview of subscription content, log in to check access.

Notes

Conflict of interest

None to declare

References

  1. 1.
    Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ (2009) Cancer statistics. Cancer J Clin 59:225–249CrossRefGoogle Scholar
  2. 2.
    Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P (2007) Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol 18:581–592PubMedCrossRefGoogle Scholar
  3. 3.
    Spiro SG, Silvestri GA (2005) One hundred years of lung cancer. Am J Respir Crit Care Med 172:523–529PubMedCrossRefGoogle Scholar
  4. 4.
    Hanagiri T, Baba T, So T et al (2010) Time trends of surgical outcome in patients with non-small cell lung cancer. J Thorac Oncol 5:825–829PubMedCrossRefGoogle Scholar
  5. 5.
    Winton T, Livingston R, Johnson D et al (2005) Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer. N Engl J Med 352:2589–2597PubMedCrossRefGoogle Scholar
  6. 6.
    Goya T, Asamura H, Yoshimura H et al (2005) Prognosis of 6644 resected non-small cell lung cancers in Japan: a Japanese lung cancer registry study. Lung Cancer 50:227–234PubMedCrossRefGoogle Scholar
  7. 7.
    Goldstraw P, Crowley J, Chansky K et al (2007) The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol 2:706–714PubMedCrossRefGoogle Scholar
  8. 8.
    Facciolo F, Cardillo G, Lopergolo M, Pallone G, Sera F, Martilli M (2001) Chest wall invasion in non-small cell lung carcinoma: a rationale for en bloc resection. J Thorac Cardiovasc Surg 121:649–656PubMedCrossRefGoogle Scholar
  9. 9.
    Akay H, Cangir AK, Kutlay H, Kavukçu S, Okten I, Yavuzer S (2002) Surgical treatment of peripheral lung cancer adherent to the parietal pleura. Eur J Cardiothorac Surg 22:615–620PubMedCrossRefGoogle Scholar
  10. 10.
    Stoelben E, Ludwig C (2009) Chest wall resection for lung cancer: indications and techniques. Eur J Cardiothorac Surg 35:450–456PubMedCrossRefGoogle Scholar
  11. 11.
    Travis WD, Colby TV, Corrin B, Shimosato Y, Brambilla E (1999) Histological type of lung and pleural tumors. World Health Organization international histological classification of tumors, 3rd edn. Springer, Berlin, pp 31–47CrossRefGoogle Scholar
  12. 12.
    Coleman FP (1947) Primary carcinoma of the lung, with invasion of the ribs pneumonectomy and simultaneous block resection of the chest wall. Ann Surg 126:156–168PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Piehler JM, Pairolero PC, Weiland LH, Offord KP, Payne WS, Bernatz PE (1982) Bronchogenic carcinoma with chest wall invasion: factors affecting survival following en bloc resection. Ann Thorac Surg 34:684–691PubMedCrossRefGoogle Scholar
  14. 14.
    Trastek VF, Pairolero PC, Piehler JM et al (1984) En bloc (non-chest wall) resection for bronchogenic carcinoma with parietal fixation. Factors affecting survival. J Thorac Cardiovasc Surg 87:352–358PubMedGoogle Scholar
  15. 15.
    Allen MS, Mathisen DJ, Grillo HC, Wain JC, Moncure AC, Hilgenberg AD (1991) Bronchogenic carcinoma with chest wall invasion. Ann Thorac Surg 51:948–951PubMedCrossRefGoogle Scholar
  16. 16.
    Ohno Y, Sugimura K, Hatabu H (2002) MR imaging of lung cancer. Eur J Radiol 44:172–181PubMedCrossRefGoogle Scholar
  17. 17.
    Akata S, Kajiwara N, Park J et al (2008) Evaluation of chest wall invasion by lung cancer using respiratory dynamic MRI. J Med Imaging Radiat Oncol 52:36–39PubMedCrossRefGoogle Scholar
  18. 18.
    Doddoli C, D’Journo B, Le Pimpec-Barthes F et al (2005) Lung cancer invading the chest wall: a plea for en-bloc resection but the need for new treatment strategies. Ann Thorac Surg 80:2032–2040PubMedCrossRefGoogle Scholar
  19. 19.
    Voltolini L, Rapicetta C, Luzzi L et al (2006) Lung cancer with chest wall involvement: predictive factors of long-term survival after surgical resection. Lung Cancer 52:359–364PubMedCrossRefGoogle Scholar
  20. 20.
    Matsuoka H, Nishio W, Okada M, Sakamoto T, Yoshimura M, Tsubota N (2004) Resection of chest wall invasion in patients with non-small cell lung cancer. Eur J Cardiothorac Surg 26:1200–1204PubMedCrossRefGoogle Scholar
  21. 21.
    McCaughan BC, Martini N, Bains MS, McCormack PM (1985) Chest wall invasion in carcinoma of the lung. Therapeutic and prognostic implications. J Thorac Cardiovasc Surg 89:836–841PubMedGoogle Scholar
  22. 22.
    Magdeleinat P, Alifano M, Benbrahem C et al (2001) Surgical treatment of lung cancer invading the chest wall: results and prognostic factors. Ann Thorac Surg 71:1094–1099PubMedCrossRefGoogle Scholar
  23. 23.
    Demir A, Gunluoglu MZ, Kara HV, Buyukpinarbasili N, Dincer SI (2008) Prognostic factors in resected T3 non-small cell lung carcinoma: perineural invasion as a new prognostic factor. Thorac Cardiovasc Surg 56:93–98PubMedCrossRefGoogle Scholar

Copyright information

© Association of Surgeons of India 2012

Authors and Affiliations

  • Takeshi Hanagiri
    • 1
  • Shinji Shinohara
    • 1
  • Masaru Takenaka
    • 1
  • Hidehiko Shimokawa
    • 1
  • Yoshika Nagata
    • 1
  • Makoto Nakagawa
    • 1
  • Hidetaka Uramoto
    • 1
  • Tomoko So
    • 1
  • Fumihiro Tanaka
    • 1
  1. 1.Second Department of Surgery, School of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan

Personalised recommendations