Back to Search Start Over

Influence of surgical resection and brachytherapy in the management of superior sulcus tumor.

Authors :
Ginsberg RJ
Martini N
Zaman M
Armstrong JG
Bains MS
Burt ME
McCormack PM
Rusch VW
Harrison LB
Source :
The Annals of thoracic surgery [Ann Thorac Surg] 1994 Jun; Vol. 57 (6), pp. 1440-5.
Publication Year :
1994

Abstract

We analyzed the results of surgical treatment of all patients presenting with untreated superior sulcus tumors between 1974 to 1991 inclusive at our institution. Most patients received preoperative radiotherapy. We attempted to analyze the influence of surgical resection and intraoperative brachytherapy in obtaining locoregional control and disease-free survival. One hundred twenty-four patients underwent thoracotomy and 100 patients underwent resection. The overall 5-year survival rate was 26% for all patients and 30% for resected patients. Those patients receiving a complete resection achieved a 41% 5-year survival. The best single group were those patients undergoing a lobectomy (versus wedge resection) and en-bloc chest wall resection (60% 5-year survival). We were unable to demonstrate an advantage for the use of intraoperative brachytherapy in those patients with complete resection. For those patients with incomplete resection, the use of brachytherapy combined with preoperative or postoperative external radiation therapy resulted in a 9% 5-year survival. Locoregional failure was significant both in patients with complete resection and in patients with incomplete resection. Adverse prognostic factors included Horner's syndrome, N2 and N3 disease, T4 disease, and incomplete resections. In superior sulcus tumors, every attempt to completely resect the tumor by en-bloc chest wall resection combined with lobectomy and adequate nodal staging remains the surgical treatment of choice together with either preoperative, postoperative, or "sandwich" external radiation therapy.

Details

Language :
English
ISSN :
0003-4975
Volume :
57
Issue :
6
Database :
MEDLINE
Journal :
The Annals of thoracic surgery
Publication Type :
Academic Journal
Accession number :
8010786
Full Text :
https://doi.org/10.1016/0003-4975(94)90098-1