Introduction: Non-small cell bronchopulmonary cancer (NSCLC) invading the chest wall is operable cancer at the cost of a parietal sacrifice. Their survival is estimated at 15% at 5 years in the literature. The factors of poor prognosis, particularly recurrence, have been studied in the literature in various ways.
Objective of this study is to describe the overall survival and the recurrence-free survival of patients operated on in our department for NSCLC invading the chest wall (parietal pleura and bone wall) and to assess prognostic factors.
Material and methods: We carried out a retrospective study on a series of cases of bronchopulmonary cancer invading the chest wall operated on in our department between 2010 and 2014. We analyzed overall and recurrence-free survival according to the Kaplan-Meier method depending of several parameters.
Results: Twenty-nine patients were operated on, all of them male, with an average age of 57 years. The main clinical sign was chest pain. Bone involvement was found in 7 patients, 22 patients presented with an invasion of the parietal pleura alone. The resection was in one piece, removing the pulmonary parenchyma and the wall in 23 patients. Parenchymal resections were dominated by lobectomy performed in 23 patients (79.31%). Seven patients were lost to follow-up. The overall survival of the patients is on average 34 +/- 4.9 months and the survival without recurrence is 24 months +/- 5.53 months. We analyzed overall survival as a function of bone involvement, monobloc resection and association with perioperative treatment. The chi-square test was respectively p = 0.659; p = 0.194; p = 402. Survival without recurrence was analyzed according to the same parameters with p = 0.197; p = 0.050; p = 0.036.
Conclusion: NSCLCs invading the chest wall are not limits to surgical resection. The association with perioperative adjuvant treatment seems to have an impact on the improvement of survival and on the occurrence of recurrence.
Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: Globocan 2008. Int J Cancer 2010:17.
Recommandations professionnelles Cancer du poumonnon à petites cellules.Collection Recommandations & référentiels, INCa, Boulogne-Billancourt, septembre 2010
National Cancer Institute . SEER [Cited 25 feb 2019.] Available from URLExplorer 2019 https://seer.cancer.gov/explorer/application.php?site=47&data_type=1&graph_type=4&compareBy=sex&chk_sex_3=3&chk_sex_2=2&chk_race_1=1&chk_age_range_1=1&advopt_precision=1&showDataFor=race_1_and_age_range_1
Santos H, Lopes J, Higa c, Nunes Acatauassu, Haruo Saito E. Lung cancer with chest wall invasion : retrospective analysis comparing en bloc resection and “resection in bird cage’. Journal of cardiothoracic Surgery 2014, 9/57 http: 3w.cardiothoracicsurgery.org/content/9/1/57.
Ratto GB, Piacenza G, Frola C et al. Chest wall involvement by lung cancer: computer tomographic detection and results of operation. Ann Thorac Surgery 1991; 51: 182-188.
Magdeleinat P., Alifano M., Benbrahem C., et al: Surgical treatment of lung cancer invading the chest wall: results and prognostic factors. Ann Thorac Surg 2001; 71: 1094-1099
Doddoli C., D’Journo B., Le Pimpec Barthes F. et al: Lung cancer invading the chest wall: a plea for en-bloc resection but the need for new treatment strategies. Ann Thorac Surg 2005; 80: pp. 2032-2040
Chang Young Lee, Chun Sung Byun, Jin Gu Lee et al The prognostic factors of resected non-small celllung cancer with chest wall invasion. World Journal of Surgical Oncology 2012, 10:9
J-P Berthet, R Vidal, P Alric, C H Marty-Ané. Stratégie thérapeutique dans les cancers bronchiques primitifs non à petites cellulles envahissant la paroi thoracique. Chirurgie Thoracique Cardio-Vasculaire - 2007 ; 11 : 117-126
Robert J. Downey, MD, Nael Martini, MD, Valerie W. Rusch et all. Extent of Chest Wall Invasion and Survival in Patients With Lung Cancer. Ann Thorac Surg 1999 ;68:188–93
Mac Caughan B.C., Martini N., Bains M.S., Mac Cormack. Chest wall invasion in carcinomas of the lung. Therapeutic and pronostic implications. J Thor Cardio-Vasc Surg 1985; 89 : 836 – 841
Ricci C., Rendina E.A., Venuta F. et al. En-Bloc resction for T3 bronchogenic carcinoma with chest wall invasion. Eur J Thor Cardio-Vasc Surg 1987; 1: 23 – 28
Casillas M., Paris F., Tarazzona V., Padilla J., Galan G. Surgical treatments of lung carcinoma involving the chest wall. Eur J Thorac Cardio-Vasc Surg 1989;3 : 425 – 429
Lopez Pujol J, Varela A, Baamonde C et al Surgical treatment of stage III non-small cell bronchogenic carcinoma involving the chest wall. Scand J Thorac Cardiovasc Surg. 1992 ; 26 :129-33
Albertucci M., Demeester T.R., Rothberg M et al. Surgery and management of peripheral lung tumors adherent to the parietal pleura. J Thorac Cardio-Vasc Surg 1992; 103 : 8 – 13
Allen M.S.: Chest wall resection and reconstruction for lung cancer. Thorac Surg Clin 2004; 14: 211-216
A. Chapelier, E. Fadel, P. Macchiarini, B. Lenot, F. Le Roy Ladurie, J. Cerrina, P. Dartevelle. Factors affecting long-term survival after en-bloc resection of lung cancer invading the chest wall. European Journal of Cardio-thoracic Surgery 2000 ;18 : 513-518
Facciolo F., Cardillo G., Lopergolo M., et al: Chest wall invasion in non-small cell lung carcinoma: a rationale for en bloc resection. J Thorac Cardiovasc Surg 2001; 121: 649-656
Riquet M., Lang-Lazdunski L., Le Pimpec Barthes F., et al: Characteristics and prognosis of resected T3 non-small cell lung cancer. Ann Thorac Surg 2002; 73: 253-258
Matsuoka H, Nishio W, Okada M, et al: Resection of chest wall invasion in patients with non-small cell lung cancer. Eur J Cardiothorac Surg 2004; 26: 1200-1204
Lin Y.T., Hsu H.S., Huang C.S., et al: En bloc resection for lung cancer with chest wall invasion. J Chin Med Assoc 2006; 69: 157-161
Stoelben E., and Ludwig C.: Chest wall resection for lung cancer: indications and techniques. Eur J Cardiothorac Surg 2009; 35: 450-456
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