Carcinoma of the superior pulmonary sulcus. Results of irradiation and radical resection

J Thorac Cardiovasc Surg. 1992 Sep;104(3):679-83.

Abstract

Fifty-six patients with superior sulcus syndrome were evaluated at the First Surgical Department of the University of Padua between 1981 and 1990. Forty-two patients with the characteristic of Pancoast's tumor received preoperative irradiation and then en bloc resection of the tumor, chest wall, and adjacent structures. Seven lobectomies and 35 segmentectomies or wedge resections were performed. There was one early postoperative death. Median survival was 14 months, and actuarial survival was 25% at 5 years. Patients with pain relief had better 5-year survival (36.4%) than patients without pain relief (9%). We have no patients with vertebral invasion who survived more than 1 year. Of the five patients with subclavian artery invasion, only one survived more than 1 year. Of five patients with N2 disease, only one survived more than 1 year. Our results suggest that pain relief after irradiation is a good prognostic factor, whereas N2 involvement and vertebral body and great vessel invasion are ominous factors. Another ominous prognostic factor is the Claude Bernard-Horner syndrome even if it is not a contraindication to resection.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / radiotherapy*
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Carcinoma / mortality
  • Carcinoma / radiotherapy*
  • Carcinoma / surgery*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / surgery*
  • Combined Modality Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Management
  • Pancoast Syndrome / mortality
  • Pancoast Syndrome / radiotherapy*
  • Pancoast Syndrome / surgery*
  • Prognosis
  • Radiotherapy Dosage
  • Time Factors