Prognostic factors after surgical treatment of lung cancer invading the diaphragm

Gaetano Rocco, Erino A. Rendina, Alberto Meroni, Federico Venuta, Claudio Della Pona, Tiziano De Giacomo, Mario Robustellini, Gerolamo Rossi, Fabio Massera, Giuseppe Vertemati, Adriano Rizzi, Giorgio F. Coloni

Research output: Contribution to journalArticlepeer-review


Background. Diaphragmatic invasion from lung cancer (T3-diaphragm) is a rare occurrence reported to portend a poor prognosis. Methods. Fifteen patients with T3-diaphragm (14 males, 1 female; median age, 64 years) were surgically treated over a twenty-year period by en bloc resection (14 patients). One patient was only explored. Pathologic stage IIB (T3N0) was found in 11 patients. A partial infiltration of the diaphragm was observed in 3 patients, whereas full-depth invasion was found in 12. Diaphragmatic reconstruction was done primarily in 9 patients, and, by prosthetic material in 5. Results. Two patients are still alive without evidence of disease at 88, and, 114 months from surgery. Overall median survival was 23 months (range, 3 to 168). The actuarial 5-year survival was 20%, when all patients were considered, and, 27%, for T3N0 patients. Univariate analysis showed that prosthetic replacement of the muscle (p = 0.018) was significantly related to survival. Conclusions. T3-diaphragm is best treated with en bloc resections with wide tumor-free margins and prosthetic replacement of the diaphragm.

Original languageEnglish
Pages (from-to)2065-2068
Number of pages4
JournalAnnals of Thoracic Surgery
Issue number6
Publication statusPublished - Dec 1999

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery


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