[Surgical treatment in non-small cell lung cancer invading to the chest wall (T3) and vertebra (T4)].

The involvement of the chest wall (T3) or the vertebra (T4) in non-small cell lung cancer (NSCLC) is seen at a ratio between 3-8% in patient's undergone surgery. The most important factors affecting the survival in both T3 and T4 tumors are the absence of lymph node invasion and a complete resection application. Amount of 162 cases were subjected to operation due to NSCLC between January 2004-July 2006. Examined retrospectively, these cases were determined to be chest wall invasion in 12 (7.4%) cases and vertebra invasion in 4 (2.5%) cases. T3 and T4 tumors with N0 lymph nodules were removed during operation. En block resection was applied to three cases with chest wall invasion and extrapleural resection was applied to nine cases. All the cases with vertebra invasion were subjected to en block resection and instrumentation. While left lower lobectomy with posterolateral thoracotomy was applied to one case following hemicorpectomy and instrumentation under posterior approach, lung resection following hemicorpectomy and instrumentation with a posterolateral thoracotomy approach were applied to two cases. However, chest wall resection without instrumentation was applied to one case following partial corpectomy. The patients underwent a complete resection and having no lymph node invasion show a long lasting survival with radiotherapy or chemoradiotherapy preoperatively and/or postoperatively.