[Surgical treatment for Pancoast tumor]

Pancoast tumor has been considered to be associated with a poor prognosis in the presence of severe chest pain and brachial and/or antebrachial pain because of brachial plexus infiltration. However, the treatment outcome was markedly improved by the introduction of trimodality therapy comprising advanced surgical resection, chemotherapy, and radiotherapy. Surgical resection after preoperative concurrent chemoradiotherapy has now been established as the standard treatment strategy. Pancoast tumor invades the surrounding tissues of the thoracic inlet area where important blood vessels and nerves run, making the surgical procedure difficult. However, there have been many advances in radical resection aiming for an improved outcome. Thus, it is possible for surgeons to select the proper surgical approach according to the location of the tumor mass. We should be careful regarding oversurgery after induction chemoradiotherapy. Therefore, the selection of patients who may benefit from surgery and improvement of surgical techniques for reduced invasiveness and complications are necessary.