Pancoast (Superior Sulcus) Tumors

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Presentation transcript:

Pancoast (Superior Sulcus) Tumors Frank C. Detterbeck, MD The Annals of Thoracic Surgery Volume 63, Issue 6, Pages 1810-1818 (June 1997) DOI: 10.1016/S0003-4975(97)00360-3

Fig. 1 Nerve involvement in a typical Pancoast tumor (C8, T1, T2, lower trunk of brachial plexus, sympathetic chain). The dermatomes of C8 and T1 are illustrated, as well as areas of referred pain in the scapular and pectoral regions (mediated through afferent fibers of the sympathetic chain). The Annals of Thoracic Surgery 1997 63, 1810-1818DOI: (10.1016/S0003-4975(97)00360-3)

Fig. 2 Survival curves of patients with Pancoast tumors who had only pleural invasion compared with those who had vascular invasion, bone invasion, or both (p = 0.003). (Reprinted with permission from Sartori F, Rea F, Calabrı̈ F, Mazzucco C, Bortolotti L, Tomio L. Carcinoma of the superior pulmonary sulcus: results of irradiation and radical resection. J Thorac Cardiovasc Surg 1992;104:679–83.) The Annals of Thoracic Surgery 1997 63, 1810-1818DOI: (10.1016/S0003-4975(97)00360-3)

Fig. 3 (A) Survival by nodal status for entire patient cohort. (B) Survival by nodal status for patients with completely resected disease. (Reprinted with permission from The Society of Thoracic Surgeons [Ann Thorac Surg 1994;57:1440–5].) The Annals of Thoracic Surgery 1997 63, 1810-1818DOI: (10.1016/S0003-4975(97)00360-3)

Fig. 4 Survival according to mediastinal node status in 128 patients with superior sulcus tumors who received or did not receive preoperative radiation therapy (preop RT). Squares indicate preoperative radiation therapy, nodes negative, n = 70; “x”’s indicate no preoperative radiation therapy, nodes negative, n = 39; triangles indicate preoperative radiation therapy, nodes positive, n = 12; and underlined “x”’s indicate no preoperative radiation therapy, nodes positive, n = 7. (neg = negative; pos = positive.) (Reprinted with permission from Hilaris BS, Martini N, Wong GY, Nori D. Treatment of superior sulcus tumor (Pancoast tumor). Surg Clin North Am 1987;67:965–77.) The Annals of Thoracic Surgery 1997 63, 1810-1818DOI: (10.1016/S0003-4975(97)00360-3)

Fig. 5 Survival rates for patients with completely resected disease according to type of pulmonary resection. (Reprinted with permission from The Society of Thoracic Surgeons [Ann Thorac Surg 1994;57:1440–5].) The Annals of Thoracic Surgery 1997 63, 1810-1818DOI: (10.1016/S0003-4975(97)00360-3)

Fig. 6 Survival of 124 patients with superior sulcus tumors. The asterisk indicates an incomplete resection curve estimated from reported data of the overall group, and those with complete resection or no resection. (Adapted with permission from The Society of Thoracic Surgeons [Ann Thorac Surg 1994;57:1440–5].) The Annals of Thoracic Surgery 1997 63, 1810-1818DOI: (10.1016/S0003-4975(97)00360-3)