Risk factors of chest wall invasion in non-small cell lung cancer

Nozomu Motono; Shun Iwai; Aika Yamagata; Yoshihito Iijima; Katsuo Usuda; Sohsuke Yamada; Hidetaka Uramoto

doi:10.21037/jtd-20-1722

Risk factors of chest wall invasion in non-small cell lung cancer

J Thorac Dis. 2021 Feb;13(2):824-830. doi: 10.21037/jtd-20-1722.

Authors

Nozomu Motono¹, Shun Iwai¹, Aika Yamagata¹, Yoshihito Iijima¹, Katsuo Usuda¹, Sohsuke Yamada², Hidetaka Uramoto¹

Affiliations

¹ Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
² Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan.

Abstract

Background: The risk factors for the development of chest wall invasion (CWI) in non-small cell lung cancer (NSCLC) patients are unclear. If the risk factors for the development of CWI can be clarified, surgical treatment might be able to be performed before CWI development, thus improving the prognosis.

Methods: In the present study, we enrolled patients who received surgery for NSCLC between January 2008 and December 2019 with available data on the maximum standardized uptake value (SUV_max) on positron emission tomography (PET) with lesions adjacent to the visceral pleura. Furthermore, the preoperative white blood cell (WBC) count, the preoperative neutrophil-to-lymphocyte ratio (NLR), platelet (Plt) count, levels of lactate dehydrogenase (LDH) and C-reactive protein (CRP) were analyzed as predictive factors of CWI.

Results: The relationships between CWI and clinicopathological variables were analyzed, and there were significant differences between patients with and without CWI in the age (P=0.02), maximum tumor diameter on computed tomography (CT) (P<0.01), diameter of tumors adjacent to the visceral pleura (P_max) (P<0.01), SUV_max (P<0.01), maximum tumor diameter on a pathological examination (P<0.01), WBC count (P=0.03), Plt count (P=0.04), and levels of LDH (P<0.01) and CRP (P=0.01). Logistic regression analyses of the risk factors related to CWI showed that the age (P=0.02), P_max (P=0.02), SUV_max (P=0.01), and LDH (P<0.01) were significant risk factors.

Conclusions: The age, P_max, SUV_max, and LDH levels might be associated with CWI.

Keywords: Chest wall invasion (CWI); non-small cell lung cancer (NSCLC); risk factor.