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Depth of chest wall invasion and lymph node metastasis in non-small cell lung cancer

Lymph node involvement is an important prognostic factor for non-small cell lung cancer. This study aims to investigate the relationship between lymph node involvement and the depth of chest wall invasion. Thirty-three patients who were operated on between 2015 and 2019 for radiologically and pathologically diagnosed chest wall invasion were retrospectively reviewed. Thirtytwo of the patients were male (97.3%) and 1 was female (2.7%) with an average age of 59.4 years. The tumor had a mean diameter of 5.81cm. The invasion was in the posterior part of the chest wall in 17 patients (51.5%), lateral in 11 (33.3%) and anterior chest wall in 5 patients (15.2%). Pleural, soft tissue and costal involvement was present in 32, 19 and 9 cases, respectively. A statistically negative correlation was observed between the depth of chest wall invasion and metastasis of lymph nodes no. 2, 4, 7, 10 and 11 (p:0.041, p:0.006, p:0.011, p:0.025, and p:0.009, respectively). As the invasion progresses towards the periphery, the result of the histopathological evaluation of the lymph nodes number 2, 4, 7, 10 and 11 was found to be benign in 73.1%, 64.6%, 91.4%, 87.5% and 64.9%, respectively. The correlation between the depth of invasion and lymph node metastasis, a subject of negligence up to now was evaluated. The findings presented herein have shown that in chest wall resections, the possibility of complete resection and the presence of lymphatic involvement which is an important prognostic marker are more important in terms of survival compared to the depth of invasion.