INVASION BEYOND INTERLOBAR PLEURA IN NONSMALL CELL LUNG-CANCER

Study objective: To assess the outcome of lung cancer with invasion be yond interlobar pleura and to clarify whether it should be treated in the same way as invasion to the parietal pleura or to other visceral p leura. Design: Retrospective analysis. Setting: Tokyo Medical College Hospital. Patients: Eighteen resected non-small cell lung cancers with invasion beyond interlobar pleura were studied. The outcomes of those patients, those with parietal pleural invasion, and those with other visceral pleural invasion were compared. Patients with rib invasion, m ediastinal organ invasion, or distant metastasis were excluded. Result s: The 5-year survival rate for patients with invasion beyond interlob ar pleura was 34.2% and the median survival time was 56.5 months. The outcome was significantly better than that of patients with parietal p leural invasion. There was no significant difference between the outco me of invasion beyond interlobar pleura and that of other visceral ple ural invasion. In patients without lymph node metastasis, similar resu lts were obtained. There was no difference between the outcome of pati ents with invasion beyond interlobar pleura, who undergo lobectomy wit h a parietal resection of the invaded lobe, and that of patients with visceral pleural invasion, who undergo lobectomy, Conclusions: The beh avior of patients with invasion beyond interlobar pleura is different from that of patients with parietal pleural invasion and should be cat egorized as T2, The optimum operative method was lobectomy with only p arietal resection of the invaded lobe to preserve the pulmonary functi on.