Abstract
Summary and conclusions 1. The thoracic wall was involved by direct extension of primary carcinoma of the lung in 33 of 392 patients who underwent resection (pneumonectomy or lobectomy). 2. Of 19 patients who had block resection of chest wall, 5 lived over 2 years. Three of these patients lived from 4 to 14 years without known recurrence of cancer. 3. In these 19 patients, the carcinoma was of squamous cell or undifferentiated cell type. 4. Extrapleural resection in 14 patients provided poor palliation, with the longest survivor living 19 months. 5. Although chest wall involvement probably indicates a less favorable outlook, such invasion does not make a patient categorically incurable by surgery. 6. If cancer of the lung, which involves chest wall, is otherwise resectable with prospect of cure, then resection must include chest wall rather than only extrapleural dissection. 7. Chest wall resection in the presence of invasion of ribs or muscle offers a measure of palliation not obtained by extrapleural dissection alone, with or without postoperative irradiation.
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