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Ann Thorac Surg 1987;43:32-38
© 1987 The Society of Thoracic Surgeons

Articles

Pancoast Tumors: Improved Survival with Preoperative and Postoperative Radiotherapy

David M. Shahian, M.D.*, Wilford B. Neptune, M.D., F. Henry Ellis, Jr., M.D., Ph.D.

From the Section of Thoracic and Cardiovascular Surgery, Lahey Clinic Medical Center, Burlington the Division of Thoracic and Cardiovascular Surgery, New England Deaconess Hospital, Boston the Overholt Thoracic Clinic, Boston Harvard Medical School, Boston, MA

* Address reprint requests to Dr. Shahian, Section of Thoracic and Cardiovascular Surgery, Lahey Clinic Medical Center, Burlington, MA 01805

Long-term survival after treatment of Pancoast tumors has been limited in most series to those patients without positive lymph nodes or residual tumor. In our series of 18 consecutive patients treated with preoperative irradiation and resection, 14 underwent supplemental postoperative radiotherapy because of positive lymph nodes, tumor at the resection margin, or both. No hospital deaths occurred. Eight patients subsequently died, 6 because of metastatic disease; only 2 deaths were secondary to local recurrence. Ten patients are alive at 6 months to 13 years after resection, and 9 of the 10 have no evidence of tumor recurrence. The overall five-year observed survival (Kaplan-Meier) for the entire series was 56.1 ± 12.7% (± standard error). Although the number of patients is small, the addition of postoperative radiotherapy for those with unfavorable operative findings resulted in long-term survival comparable to that of patients with negative nodes and margins.




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