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Updated: Apr 25, 2026

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Surgery for Superior Sulcus Tumor, Partially Using a Robotic Approach, After Neoadjuvant Nivolumab With
Hitoshi Igai1, Akinobu Ida1, Kazuki Numajiri1
1Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Japan.
Abstract:
Superior sulcus tumors have traditionally been treated with concurrent chemoradiotherapy followed by surgical resection, although radiation-induced fibrosis complicates surgery. Recent studies suggest that neoadjuvant nivolumab combined with platinum-based chemotherapy improves prognosis while limiting perioperative complications. We successfully performed surgical resection of a superior sulcus tumor by using a hybrid approach: an L-shaped incision for chest wall resection and a robotic-assisted technique for left upper lobectomy and lymphadenectomy. The patient achieved a major pathologic response with an uneventful recovery. This case highlights the potential of neoadjuvant immunochemotherapy and robotic surgery in optimizing outcomes for superior sulcus tumor management.
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