International Journal of Hematology and Oncology 2021, Vol 31, Num 4 Page(s): 089-095
Factors Affecting the Prognosis of non-Small Cell Lung Cancer with Chest Wall / Parietal Pleural Invasion (T3) Following Resection

Ahmet UCVET1, Soner GURSOY1, Ahmet E. ERBAYCU2, Cemil KUL1, Halil TOZUM1, Sinan ANAR1, Zekiye A. DINC3

1Dr Suat Seren Chest Diseases Training and Research Hospital, Department of Thoracic Surgery, Izmir, TURKEY
2Dr Suat Seren Chest Diseases Training and Research Hospital, Department of Pulmonary Diseases, Izmir, TURKEY
3Dr Suat Seren Chest Diseases Training and Research Hospital, Department of Pathology, Izmir, TURKEY

Keywords: Lung cancer, Parietal pleura, Chest wall, Pneumonectomy, Lobectomy, Complete resection
Chest wall involvement occurs in approximately 5% of all patients with newly diagnosed non-small cell lung cancer (NSCLC). In the absence of metastatic spread, en bloc anatomic surgical resection of the involved lung and chest wall is the primary treatment for most of these patients. The aim of our study was to investigate the possible factors that could affect long-term survival after surgery in a homogenous group of patients affected by NSCLC invading the chest wall/parietal pleura (T3). NSCLC patients with chest wall/ parietal pleural invasion who underwent surgical treatment between February 1996 and December 2005 were included in this study. A total of 50 male patients with a mean age of 60.9 years were included in the study. The follow-up period for these patients was 26.1 months, the median survival was 17.8 months, and the 5-year survival rate was 45.1%. The survival rate was better in patients who underwent a pneumonectomy than a lobectomy, patients with no residual disease than those with residual disease, and patients with complete resection than those with incomplete resection. Operative mortality was 9.6%; 3 (25.0%) pneumonectomy and 2 lobectomy (5.6%). Survival was not affected by age, extrapleural dissection or chest wall resection, size of the tumor, tumor histology and differentiation, invasion of the chest wall or parietal pleura, N status, stage, neoadjuvant therapy, administration of adjuvant therapy, procedure of adjuvant therapy, and dimension of the chest wall.

Surgical resection is an effective treatment in non-small cell lung cancer with chest wall or parietal pleural invasion (T3). The absence of concomitant diseases, pneumonectomy, and complete resection are good prognostic factors.