Pancoast Tumors: 11-Year Single-Centre Experience

Pancoast tumors encompass any tumor located on the lung apex, extending into structures in the thoracic inlet and, often, leading to the characteristic clinical syndrome. The main goal of this study is to analyze the response to multimodal treatment and outcome of patients with Pancoast tumors.

We performed a retrospective cohort single center study of patients with superior sulcus nonsmall cell lung carcinomas who underwent surgery between January of 2011 and February of 2022.

A total of ten patients were considered, 80,0% were male with a mean age of 53,6 (±6,6) years. At diagnosis, two tumors were stage II and eight were stage III. Histopathology revealed eight were adenocarcinomas and two were sarcomatoid carcinomas. All patients underwent neoadjuvant treatment before surgery. Nine patients received lung lobectomy, with en bloc resection comprising, predominantly, the chest wall (80,0%) and brachial plexus (30,0%). In one patient, surgery was aborted. Surgical histopathology showed free surgical margins were achieved in eight patients (80,0%). Two patients achieved full tumoral remission (ypT0N0, 22,2%), two tumors were stage I (22,2%), two were stage II (22,2%), two were stage III (22,2%) and one tumor was stage IV (11,1%). Mean disease-free survival was 83,9 (CI95% 42,1-125,8) months. 3-month disease-free survival rate was 88,9% and 1-year and 5-year disease-free survival rates were 63,5%. After the first-year follow-up, there was no evidence of disease progression. Mean overall survival was 115,7 (CI95% 89,3-142,1) months. At 3-month, 1-year and 5-years, overall survival was 88,9%.

Although considering the small sample of patients, the survival of Pancoast tumors in our institution exhibits a positive outcome, when compared to current literature, Significant improvements have been reported recently, in understanding the nature of Pancoast tumors, emphasizing the importance of a multidisciplinary approach but still, further research is required.