title: Primary lung tumors invading the chest wall.
abstract: Chest wall (CW) involvement occurs in approximately 5% of all primary lung neoplasms. According to the most recent TNM classification, lung tumors invading CW are classified as T3, and they represent approximately 45% of all T3 lung cancers. The most common clinical symptom at presentation is chest pain (>60%), which is highly specific of CW infiltration (>90%). Dyspnoea and hemoptysis are also described, especially in case of large lesions. A realistic chance to cure locally advanced tumors invading CW is a surgical resection, consisting in the excision of the primary lung cancer along with the involved CW (sometimes an "en-bloc" resection) and an appropriate lymph-nodal dissection. However, such patients are at high-risk of facing postoperative complications; prognosis mainly depends on: (I) the completeness of resection; and (II) the lymph-nodal involvement. Hence, due to these reasons (incidence, symptoms, prognosis, post-operative complications), such category of patients are to be carefully assessed preoperatively and if deemed practicable, surgery should be taken into consideration. In this view, the aim of this paper is to critically review the most recent series of lung tumors invading the CW, with a particular focus on patients' preoperative evaluation, surgical techniques, postoperative complications and overall outcome.
authors.affiliation: Department of Thoracic Surgery, University of Torino Italy, Torino, Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Filosso
authors.affiliation: Department of Thoracic Surgery, University of Torino Italy, Torino, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Sandri
authors.affiliation: Department of Thoracic Surgery, University of Torino Italy, Torino, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Guerrera
authors.affiliation: San Giovanni Battista Hospital, Service of Pulmonology, Via Genova, Torino, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Solidoro
authors.affiliation: Department of Thoracic Surgery, University of Torino Italy, Torino, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bora
authors.affiliation: Department of Thoracic Surgery, University of Torino Italy, Torino, Italy.
authors.forename: Paraskevas
authors.initials: P
authors.lastname: Lyberis
authors.affiliation: Department of Thoracic Surgery, University of Torino Italy, Torino, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ruffini
authors.affiliation: Department of Thoracic Surgery, University of Torino Italy, Torino, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Oliaro
keywords: Primary lung cancer; adjuvant therapy; chest wall reconstruction; chest wall resection; induction therapy; n2