[The surgical treatment of the Pancoast tumor]

A retrospective study was made of eight patients who underwent operation in the period 1974-1987 because of a Pancoast (pulmonary sulcus) tumour. Of the five patients still alive, three have had no local recurrences for 15, 4 and 2 years, respectively, after the operation. Data from this investigation and from the literature confirm that the absence of metastases in mediastinal lymph nodes, and use of preoperative irradiation may have a favourable effect on the prognosis. The best result is achieved with preoperative irradiation followed by 'en bloc' resection of the affected pulmonary lobe, the tumour-infiltrated chest wall and, if necessary, part of the sympathetic trunk and the plexus brachialis inferior. Emphasis is laid on the importance of early recognition of the tumour in case of aspecific shoulder and arm symptoms.