Primary lung tumors invading the chest wall

Abstract

Objective: Lung cancer remains the leading cause of cancer deaths worldwide. The surgical approach to locally advanced non-small cell lung cancer (NSCLC) goes beyond the classical approach and requires a multidisciplinary approach both preoperatively and postoperatively. In addition to the tumor size, the location of T3 tumors affects the extent of the surgery. Materials and Methods: Patients who underwent lung resection for cancer between March 2019 and October 2022 were retrospectively reviewed. Patients who underwent chest wall resection were evaluated in terms of age, gender, pathology, type of operation, survival, recurrence, complications, receipt of preoperative chemotherapy, tumor node metastasis (TNM) stage, whether or not mediastinoscopy was performed, STAS (The spread through air spaces) positivity, visceral pleural invasion, parietal pleural invasion, lymphovascular invasion, perineural invasion, and alveolar/bronchial wall invasion. Results: Thoracic wall resection was performed in nine patients with locally advanced NSCLC. The use of prolene mesh was required in eight patients. All patients complained of pain in the thoracic wall in the preoperative period. Postoperative pathology results showed STAS positivity in four patients; alveolar/bronchial wall invasion in four; and visceral, parietal, pleural, and lymphovascular invasion in seven. The mean survival of the patients was 24.20 months (0.63–39). No patient developed recurrence during the follow-up period. Conclusion: Chest wall resection and reconstruction for lung cancer is a surgical treatment method that should be performed without violating respiratory physiology and by using a small amount/number of synthetic materials.

Keywords

• Lung
• Thoracic surgery
• Cancer
• Thoracic wall

Göğüs duvarını invaze eden primer akciğer tümörleri

Abstract

Amaç: Akciğer Kanseri dünya çapında kanser ölümlerinin önde gelen nedeni olmaya devam etmektedir. Lokal ileri küçük hücreli dışı akciğer kanserinde (khdak) cerrahi yaklaşım klasik yaklaşımın ötesine geçerek hem preoperatif hem de post operatif multidisipliner yaklaşım ihtiyacını doğurur. Tümörün boyutunun büyüklüğüne ek olarak boyuttan bağımsız T3 tümörlerin yerleşim yeri uygulanacak cerrahinin büyüklüğünü etkiler. Gereç ve Yöntem: Patients who underwent lung resection for malignancy between March 2019 and October 2022 were retrospectively examined. Göğü duvarı rezeksiyonu uygulanan hastalar yaş, cinsiyet, patoloji, operasyon şekli, sağkalım, nüks, komplikasyonlar, preoperatif kemoterapi alıp-almadığı, TNM evresi, mediastinoskopi yapılıp-yapılmadığı, STAS ( The spread through air spaces) pozitifliği, visseral plevra invazyonu, paryetal plevra invazyonu, lenfovasküler invazyon, perinöral invazyon ve alveol/bronş duvarı invazyonu açısından değerlendirildi. Bulgular: Lokal ileri küçük hücreli dışı akciğer kanseri nedeniyle 9 hastaya toraks duvarı rezeksiyonu uygulanmıştır. Hastaların 8’indee prolen mesh kullanma ihtiyacı doğmuştur. Tüm hastalarda preoperatif dönemde toraks duvarında ağrı şikayeti mevcuttu. Postoperatif patoloji sonuçlarında hastaların 4’ünde STAS pozitifliği, 4’ünde alveol/bronş duvarı invazyonu, 7’sinde visseral, paryetal plevra ve lenfovasküler invazyon tespit edilmiştir. Hastaların ortalam sağ kalım süresi 24,20 ay (0,63-39) olarak tespit edilmiştir. Takip süresi içerisinde nüks gelişen hasta olmamıştır. Sonuç: Akciğer kanseri nedeniyle gerçekleştirilen göğüs duvarı rezeksiyonu ve rekonstrüksiyonu solunum fizyolojisine aykırı davralınmadan ve az miktarda/sayıda sentetik materyal tercih edilerek gerçekleştirilmesi gereken bir cerrahi tedavi yöntemidir.

Keywords

• Akciğer
• Göğüs cerrahisi
• Kanser
• Toraks duvarı

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