Surgical Treatment of Superior Sulcus Tumors

Abstract

Although superior sulcus tumors are still complex, preoperative induction therapy followed by complete resection seemed effective for prolonging survival.

Management of Locally Advanced Pancoast (Superior Sulcus) Tumors with Spine Involvement

“…Among reported series on surgical treatment of locally advanced Pancoast tumors, mortality rates ranged from 0% to 5%, and complication rates ranged from 28% to 52%. 15,16,19,33 The most frequent complications in these series were the result of pulmonary issues such as prolonged intubation for respiratory failure, pneumonia, and atelectasis.…”

“…Selected papers were graded by level of evidence according to Sackett criteria. 17 The results of the literature search are tabulated in Table 1 10,[18][19][20][21][22][23] and Table 2. 12,[24][25][26][27][28][29] A total of 1,001 abstracts and 93 articles fulfilled the inclusion criteria.…”

“…The introduction of combined concurrent chemotherapy with radiotherapy as induction therapy has significantly increased survival rates in patients with Pancoast tumors compared with radiotherapy alone. 10,[18][19][20][21][22][23] Although level 1 studies do not exist, newer studies that exclusively use neoadjuvant chemotherapy plus radiation therapy as part of trimodality protocols have confirmed the safety and feasibility of these treatment strategies and have shown improved survival rates in patients with complete resections. Furthermore, the treatment was well tolerated with acceptable rates of mortality and morbidity.…”

Superior sulcus tumors with vertebral body involvement: A multimodality approach

“…Nevertheless, several small retrospective series have demonstrated the feasibility of performing either partial or total vertebrectomy for select patients with vertebral invasion, and survival appears to be improved relative to that seen in historical control subjects. [2][3][4][5][6][7] In 1999, we reported a series of 17 patients who underwent resection of superior sulcus tumors that involved the spine. 4 Overall 2year survival was 54%, but it was 80% in patients with negative margins.…”

Single-Stage Posterior Approach for the En Bloc Resection and Spinal Reconstruction of T4 Pancoast Tumors Invading the Spine

“…The mean length of hospitalization of our patients was 44±18 days, which was longer than that (9-11 days) reported in previous studies [16,22,23]. Previous studies showed that the surgical treatment of locally advanced Pancoast tumors is a highly complex procedure with a high complication rate, which ranges from 28% to 53.2% [14,[22][23][24][25][26][27]. The major complication HV, hemivertebrectomy; PC, partial corpectomy; TV, total vertebrectomy; R0: negative surgical margin; R1: microscopically positive surgical margin; SD, standard deviation.…”