T3 Chest Wall Involvement

Chest wall invasion by lung carcinoma occurs in approximately 5% with a 5 year post-resection survival rate of approximately 1 in 3 when regional lymph nodes are negative. There is general agreement that full thickness chest wall resection is indicated in patients with nonsmall cell lung cancer invading the chest wall. There is some disagreement if the tumor extension appears to involve only the parietal pleura. Some feel that an extrapleural dissection should be attempted and if a plane is readily achieved, then only an extrapleural resection should be performed without chest wall resection. However most feel that if the parietal pleura is involved then formal chest wall resection is indicated. The role of adjuvant radiation therapy has not yet been defined.

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