Usefulness of Video-assisted Thoracoscopy for Correctly Staging Tumors as T3 Because of Chest Wall Invasion

Pleural Tags on CT Scans to Predict Visceral Pleural Invasion of Non–Small Cell Lung Cancer That Does Not Abut the Pleura

“…A clear extrapleural fat plane adjacent to the mass, on the other hand, cannot definitely exclude chest wall invasion (16). The accuracy of CT in cases where the tumor is adjacent to the chest wall without any bone destruction is low, with sensitivity ranging from 38% to 90% and specificity from 40% to 96% (5,6). CT image features, such as a broad area of contact (.3 cm in each direction) between the mass and the pleura, an obtuse angle between the tumor and the chest wall, and an adjacent pleural thickening, are usually considered to be signs of chest wall invasion (5,7,8,16).…”

“…predictive value (PPV) for detection of parietal pleura and chest wall invasion (4). The diagnostic accuracy, sensitivity, and specificity of CT for detection of invasion of the parietal pleura or chest wall by peripheral lung cancer that abuts the pleural surface have been reported (5,6) to be 56%-89%, 38%-90%, and 40%-96%, respectively. Most studies of the pleural invasion of lung cancer focused on peripheral lung cancer that abuts the pleura with extension to the parietal pleura, chest wall, and mediastinum (4,5,7,8).…”

Lobectomy for Non-Small Cell Lung Cancer by Video-Assisted Thoracic Surgery: Effects of Cumulative Institutional Experience on Adequacy of Lymphadenectomy

“…Previous studies by us and others have reported the feasibility and safety of the VATS approach in elderly patients, in patients with limited pulmonary functions, and in patients with locally advanced tumors. VATS was associated with lower morbidity compared with the open approach in these patients [5,[15][16][17][18][19][20][21][22][23][24][25].…”