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The Annals of Thoracic Surgery, Vol 51, 948-951, Copyright © 1991 by The Society of Thoracic Surgeons
MS Allen, DJ Mathisen, HC Grillo, JC Wain, AC Moncure and AD Hilgenberg
Bronchogenic carcinoma with chest wall involvement continues to present a
major clinical challenge. We have treated 52 patients since 1973, excluding
those with superior sulcus tumors. There were 37 male and 15 female
patients with an average age of 62.9 years. Chest pain was an initial
symptom in 37%. All patients had negative mediastinoscopy results. Squamous
cell carcinoma was present in 53% and adenocarcinoma in 35%. The median
number of ribs resected was two (range, one to six), and only 2 patients
required chest wall reconstruction. Pathologic staging was T3 N0 M0 in 83%
and T3 N1 M0 in 17%. Operative mortality was 3.8%. Absolute 5-year survival
was 26.3%. Patients who had N1 disease had a 5-year survival of only 11%.
Radiation therapy was employed in 46% for positive nodes or close margins.
Bronchogenic carcinoma with chest wall invasion remains potentially curable
if N2 nodes are not involved. The role of radiation therapy has not been
clearly defined. Morbidity and mortality should be minimal.
ARTICLES
Bronchogenic carcinoma with chest wall invasion
Department of Thoracic Surgery, Massachusetts General Hospital, Boston 02114.
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