Huang Luyu, Li Feng, Neudecker Jens, Elsner Aron, Strauchmann Julia, Dziodzio Tomasz, Zhou Haiyu, Rueckert Jens
Department of Surgery, Competence Center of Thoracic Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
J Thorac Dis. 2024 Jul 30;16(7):4794-4806. doi: 10.21037/jtd-23-774. Epub 2024 Jul 26.
The development of early screening for lung cancer has led to improved overall survival in patients with non-small cell lung cancer (NSCLC). However, the management of NSCLC patients with resectable and potentially resectable chest wall invasion (CWI) requires attention. The purpose of this review is to summarize the role of surgery (chest wall resections) in NSCLC patients with CWI.
A literature search and review from three databases (PubMed, Embase, and ScienceDirect) comprised the last 39 years. This review was focused on the treatment of NSCLC patients with CWI, mainly including the preoperative evaluation, principles of treatment and strategic decision-making, surgical complications, and prognostic factors.
Through the collection of relevant literature on NSCLC that invades the chest wall, this narrative review describes the actual role in clinical practice and future developments of chest wall resections. Preoperative treatment requires the multidisciplinary team (MDT) team to conduct accurate clinical staging of the patient and pay attention to the patient's lymph node status and rib invasion status. The successful implementation of chest wall resection and possible chest wall reconstruction requires refined individualized treatment based on the patient's clinical characteristics, supplemented by possible postoperative systemic treatment.
Surgery plays an important role in treating NSCLC patients with CWI, and a collaborative, experienced MDT is an essential component of the successful treatment of CWI with lung cancer. In the future, more high-quality clinical research is needed to focus on CWI patients so that patients can receive more effective treatment options and better clinical prognosis.
肺癌早期筛查的发展已使非小细胞肺癌（NSCLC）患者的总生存率得到提高。然而，NSCLC合并可切除及潜在可切除胸壁侵犯（CWI）患者的管理仍需关注。本综述的目的是总结手术（胸壁切除术）在合并CWI的NSCLC患者中的作用。
对三个数据库（PubMed、Embase和ScienceDirect）过去39年的文献进行检索和综述。本综述聚焦于合并CWI的NSCLC患者的治疗，主要包括术前评估、治疗原则与策略决策、手术并发症及预后因素。
通过收集有关侵犯胸壁的NSCLC的相关文献，本叙述性综述描述了胸壁切除术在临床实践中的实际作用及未来发展。术前治疗需要多学科团队（MDT）对患者进行准确的临床分期，并关注患者的淋巴结状态和肋骨侵犯情况。胸壁切除术的成功实施及可能的胸壁重建需要根据患者的临床特征进行精细的个体化治疗，并辅以可能的术后全身治疗。
手术在治疗合并CWI的NSCLC患者中起着重要作用，协作且经验丰富的MDT是成功治疗肺癌合并CWI的重要组成部分。未来，需要更多高质量的临床研究聚焦于CWI患者，以便患者能获得更有效的治疗选择和更好的临床预后。
