Chest wall involvement is seen in approximately 5% of patients with newly diagnosed non-small cell lung cancer (NSCLC). In the absence of metastatic spread, en bloc anatomic surgical resection of the involved lung and chest wall is the primary treatment for most of these patients.1
By definition, chest wall invasion is at least T3 disease (T4 when vertebral body invasion is present). Superior sulcus or Pancoast tumors also are lesions associated with chest wall involvement, but traditionally these have been discussed and treated as a separate entity because of their different presentations, the particularities of their surgical management, and possibly their prognostic features. Therefore they have not been included in this discussion.