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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adenocarcinoma, Aged, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Female, Humans, Immunohistochemistry, Lung Neoplasms, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Metastasis, Neoplasm Recurrence, Local, Retrospective Studies, Survival Analysis, Thoracic Wall, Thoracotomy, Treatment Outcome.
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Does immunohistochemistry-detected microscopic tumor spread affect outcome in en-bloc resection for T3-chest wall lung cancer? Context: This study is aimed at analyzing the effect of immunohistochemistry-detected microscopic tumor spread on long-term survival after en-bloc lung and chest wall resection for T3-chest wall non-small cell lung cancer (NSCLC). We retrospectively reviewed 47 patients (mean age 64.4+/-7.1 years, range 48-77) who underwent radical en-bloc lung and chest wall resection for NSCLC between 1987 and 2000. Resection margins, invasion depth, and lymph nodes were re-assessed by immunohistochemistry with AE1/AE3 anti-cytokeratin and anti-CEA monoclonal antibodies. Operative mortality and morbidity were 2.1% and 34%, respectively. At immunohistochemistry analysis, five patients (10.6%) revealed microinfiltration of the resection margins that was significantly correlated with the development of local recurrence (p<0.005). Nodal micrometastases were found in 4 out of 33 N0 patients (12.1%), and correlated with distant relapse (p<0.001). Overall and disease-free survivals were significantly influenced by N-status (p<0.001), especially after re-evaluation of micrometastases (p<0.0001), and resection margins microinfiltration (p<0.0001) being these last two the only significant prognostic factors at Cox regression analysis. Five-year overall survival in radically resected patients was 73%.
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In this study immunohistochemical analysis allowed to identify patients at higher risk of recurrence following en-bloc resection for T3-chest wall NSCLC. Final Decision: yes