| Abstract
| - Forty-three patients with lung cancer who had undergone combined resection of chest wall and lung between May 1962 and April 1972 were studied, and the relation of the depth of the tumor invasion into the chest wall to the survival rate was investigated. The types of invasion were classified as follows: p0; the tumor invasion confined only in the lung, p1; the invasion reached to the visceral pleura but not beyond it. p2; the visceral pleura was apparently invaded. p3; the invasion extended into the parietal pleura or chest wall. Six of the 43 patients considered as being p3 during surgery revealed histopathologically to be p1 or p2. Three of the six with pi or p2 and five of the 37 with p3 survived more than five years. The 5-year survival rates were 50% and 13.5%, respectively. There were no patients with hilar or mediastinal lymph node metastasis among these survivors. In four of the five survivors with p3, the tumor did not invade the muscle layer or the rib, and the invasion was observed only in the parietal pleura and/or the subpleural adipose tissue. The prognosis of patients, who had adhesion to the chest wall at the tumor site and underwent combined chest wall and lung resection, depended strongly on the depth of cancer invasion into the chest wall. The five-year survivors among patients with the combined resection revealed that the cancer did not invade outside the lung histopathologically. Even in those patients with histologically proven invasion into the chest wall, the slighter the depth of invasion, the better the prognosis.
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