Primary lung cancer with chest wall involvement: Outcomes of a multimodality management approach
Open Access
- 1 January 2021
- journal article
- research article
- Published by Medknow in Lung India
- Vol. 38 (4), 338-342
- https://doi.org/10.4103/lungindia.lungindia_725_20
Abstract
Introduction: The incidence of lung cancer with chest wall (CW) involvement is approximately 5%. Surgical resection with tumor-free margin is the mainstay of the treatment but these patients generally require multimodality management. CW resection for lung cancer is a complex procedure and requires a balance of radical oncological resection and reconstruction. Herein, we shared an experience of primary lung cancer with CW involvement. Materials and Methods: Outcome analysis of a prospectively maintained lung cancer database was done for the patients having primary lung cancer with CW involvement. All the patients underwent radical surgical resection of the primary tumor along with the CW. Results: Among the 208 patients undergoing surgery for non-small cell lung cancer, 20 (9.5%) were found to have CW involvement radiologically. The most common symptom was chronic cough. A total of 11 patients received neoadjuvant chemotherapy (NACT) and the rest were taken for upfront surgery. Six patients had a partial response to NACT and none of them had tumor progression during the chemotherapy. All the patients underwent en bloc resection of the CW with anatomical resection of lung and systematic mediastinal lymphadenectomy. The mean duration of surgery was 199 min and the average blood loss was 560 ml. Reconstruction was done with a combination of prosthetic mesh and pedicled muscle flap. Median disease-free and overall survivals were 21 and 26 months, respectively. Conclusion: Radical resection with reconstruction is required for optimal long-term oncological and functional outcomes for NSCLC with CW involvement.Keywords
This publication has 15 references indexed in Scilit:
- Chest-wall reconstruction with a customized titanium-alloy prosthesis fabricated by 3D printing and rapid prototypingJournal of Cardiothoracic Surgery, 2018
- Outcomes in Lung Cancer: 9-Year Experience From a Tertiary Cancer Center in IndiaJournal of Global Oncology, 2017
- Primary lung tumors invading the chest wallJournal of Thoracic Disease, 2016
- Chest Wall Resection and ReconstructionThoracic Surgery Clinics, 2015
- Non–Small Cell Lung Cancer Invading the Chest WallThoracic Surgery Clinics, 2010
- Lung Cancer Invading the Chest Wall: A Plea for En-Bloc Resection but the Need for New Treatment StrategiesThe Annals of Thoracic Surgery, 2005
- Postoperative chemotherapy for non–small cell lung cancer: A systematic review and meta-analysisThe Journal of Thoracic and Cardiovascular Surgery, 2004
- Comparison of imaging TNM [(i)TNM] and pathological TNM [pTNM] in staging of bronchogenic carcinomaEuropean Journal of Cardio-Thoracic Surgery, 1997
- Tumor invasion of the chest wall in lung cancer: diagnosis with US.Radiology, 1993
- Chest wall invasion by lung cancer: limitations of CT evaluationAmerican Journal of Roentgenology, 1985