Survival and Prognostic Factors of Patients Operated for Bronchopulmonary Cancer Invading the Chest Wall at Ibn Sina Hospital in Rabat (Morocco)

Abstract

Introduction: Non-small cell bronchopulmonary cancer (NSCLC) invading the chest wall is operable cancer at the cost of a parietal sacrifice. Their survival is estimated at 15% at 5 years in the literature. The factors of poor prognosis, particularly recurrence, have been studied in the literature in various ways.Objective of this study is to describe the overall survival and the recurrence-free survival of patients operated on in our department for NSCLC invading the chest wall (parietal pleura and bone wall) and to assess prognostic factors.Material and methods: We carried out a retrospective study on a series of cases of bronchopulmonary cancer invading the chest wall operated on in our department between 2010 and 2014. We analyzed overall and recurrence-free survival according to the Kaplan-Meier method depending of several parameters.Results: Twenty-nine patients were operated on, all of them male, with an average age of 57 years. The main clinical sign was chest pain. Bone involvement was found in 7 patients, 22 patients presented with an invasion of the parietal pleura alone. The resection was in one piece, removing the pulmonary parenchyma and the wall in 23 patients. Parenchymal resections were dominated by lobectomy performed in 23 patients (79.31%). Seven patients were lost to follow-up. The overall survival of the patients is on average 34 +/- 4.9 months and the survival without recurrence is 24 months +/- 5.53 months. We analyzed overall survival as a function of bone involvement, monobloc resection and association with perioperative treatment. The chi-square test was respectively p = 0.659; p = 0.194; p = 402. Survival without recurrence was analyzed according to the same parameters with p = 0.197; p = 0.050; p = 0.036.Conclusion: NSCLCs invading the chest wall are not limits to surgical resection. The association with perioperative adjuvant treatment seems to have an impact on the improvement of survival and on the occurrence of recurrence.