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Superior pulmonary sulcus carcinoma.

H C Urschel1

  • 1Thoracic and Cardiovascular Surgery, University of Texas Health Science Center, Dallas.

The Surgical Clinics of North America
|June 1, 1988
PubMed
Summary

Pancoast's syndrome, caused by superior pulmonary sulcus carcinomas, can be treated with preoperative irradiation followed by surgical resection. This combined approach offers a five-year survival rate exceeding 30% for carefully selected patients.

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Area of Science:

  • Thoracic Oncology
  • Surgical Oncology
  • Radiation Oncology

Background:

  • Superior pulmonary sulcus tumors often present as Pancoast's syndrome, characterized by shoulder/arm pain and Horner's syndrome.
  • Early diagnosis and staging are crucial for effective treatment planning.

Purpose of the Study:

  • To outline a therapeutic strategy for Pancoast's syndrome.
  • To identify patient selection criteria and contraindications for combined modality treatment.

Main Methods:

  • Preoperative irradiation (3000 rads over 2-3 weeks) followed by a 2-4 week interval.
  • En bloc surgical resection of the chest wall, lower brachial plexus, and lung.

Main Results:

  • A five-year survival rate greater than 30% was achieved with this multimodality approach.
  • Careful patient selection based on tumor extent and metastasis is key.

Conclusions:

  • Combined preoperative irradiation and surgical resection is a viable treatment for selected Pancoast's syndrome patients.
  • Contraindications include extensive local invasion or distant metastases.

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