HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Pascal Thomas Alain J. Wurtz Marcel Dahan Marc Riquet Antoine Dujon Roger Giudicelli Pierre Fuentes Jacques F. Azorin Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Martinod, E. Articles by Azorin, J. F. Search for Related Content PubMed PubMed Citation Articles by Martinod, E. Articles by Azorin, J. F. Related Collections Lung - cancer Related Article

Ann Thorac Surg 2002;73:1534-1539
© 2002 The Society of Thoracic Surgeons

---

Original article: general thoracic

Management of superior sulcus tumors: experience with 139 cases treated by surgical resection

^a Department of Thoracic and Vascular Surgery, Hôpital Avicenne, Bobigny, France
^b Department of General Thoracic Surgery, Hôpital Sainte-Marguerite, Marseille, France
^c Department of General Thoracic Surgery, Hôpital Calmette, Lille, France
^d Department of General Thoracic Surgery, Hôpital Purpan, Toulouse, France
^e Department of General Thoracic Surgery, Hôpital Européen Georges Pompidou, Paris, France
^f Department of General Thoracic Surgery, Clinique des Cèdres, Bois-Guillaume, France
^g Department of General Thoracic Surgery, Hôpital Militaire Percy, Clamart, France

Accepted for publication December 28, 2001.

* Address reprint requests to Dr Martinod, Service de Chirurgie Thoracique et Vasculaire, Hôpital Avicenne, 125 Route de Stalingrad, 93000 Bobigny, France
e-mail: emartinod{at}wanadoo.fr

Background. The management of non-small cell carcinomas of the lung involving the superior sulcus remains controversial. The goal of this retrospective study was to evaluate the role of surgery, radiotherapy, and chemotherapy for the treatment of superior sulcus tumors, to define the best surgical approach for radical resection, and to identify factors influencing long-term survival.

Methods. Between 1983 and 1999, 139 patients underwent surgical resection of superior sulcus tumors in seven thoracic surgery centers. According to the classification of the American Joint Committee, 51.1% of cancers were stage IIB, 13.7% stage IIIA, 32.4% stage IIIB, and 2.9% stage IV.

Results. The resections were performed with 74.1% using the posterior approach and 25.9% using an anterior approach. A lobectomy was accomplished in 69.8% of the cases and a wedge resection in 22.3%. Resection of a segment of vertebrae or subclavian artery was performed, respectively, in 19.4% and 18% of the cases. Resection was complete in 81.3% of cancers. The overall 5-year survival rate was 35%. Preoperative radiotherapy improved 5-year survival for stages IIB–IIIA. Surgical approach, postoperative radiotherapy, or chemotherapy did not change survival.

Conclusions. The optimal treatment for superior sulcus tumors is complete surgical resection. The surgical approach (anterior/posterior) did not influence the 5-year survival rate. Preoperative radiotherapy should be recommended to improve outcome of patients with a superior sulcus tumor.

Related Article

Invited commentary

David M. Shahian
Ann. Thorac. Surg. 2002 73: 1539-1540. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				J. F. Bruzzi, R. Komaki, G. L. Walsh, M. T. Truong, G. W. Gladish, R. F. Munden, and J. J. Erasmus Imaging of Non-Small Cell Lung Cancer of the Superior Sulcus: Part 1: Anatomy, Clinical Manifestations, and Management RadioGraphics, March 1, 2008; 28(2): 551 - 560. [Abstract] [Full Text] [PDF]

				H. Kunitoh, H. Kato, M. Tsuboi, T. Shibata, H. Asamura, Y. Ichonose, N. Katakami, K. Nagai, T. Mitsudomi, A. Matsumura, et al. Phase II Trial of Preoperative Chemoradiotherapy Followed by Surgical Resection in Patients With Superior Sulcus Non-Small-Cell Lung Cancers: Report of Japan Clinical Oncology Group Trial 9806 J. Clin. Oncol., February 1, 2008; 26(4): 644 - 649. [Abstract] [Full Text] [PDF]

				L. Spaggiari, M. D'Aiuto, G. Veronesi, F. Leo, P. Solli, M. Elena Leon, R. Gasparri, D. Galetta, F. Petrella, A. Borri, et al. Anterior approach for Pancoast tumor resection MMCTS, October 18, 2007; 2007(1018): 1776. [Abstract] [Full Text] [PDF]

				V. W. Rusch, D. J. Giroux, M. J. Kraut, J. Crowley, M. Hazuka, T. Winton, D. H. Johnson, L. Shulman, F. Shepherd, C. Deschamps, et al. Induction Chemoradiation and Surgical Resection for Superior Sulcus Non-Small-Cell Lung Carcinomas: Long-Term Results of Southwest Oncology Group Trial 9416 (Intergroup Trial 0160) J. Clin. Oncol., January 20, 2007; 25(3): 313 - 318. [Abstract] [Full Text] [PDF]

				V. C. Archie and C. R. Thomas Jr. Superior Sulcus Tumors: A Mini-Review Oncologist, September 1, 2004; 9(5): 550 - 555. [Abstract] [Full Text] [PDF]

				C. C.M. Pitz, A. B. de la Riviere, H. A. van Swieten, V. A.M. Duurkens, J.-W. J. Lammers, and J. M.M. van den Bosch Surgical treatment of Pancoast tumours Eur. J. Cardiothorac. Surg., July 1, 2004; 26(1): 202 - 208. [Abstract] [Full Text] [PDF]

				M. Alifano, M. D'Aiuto, P. Magdeleinat, E. Poupardin, A. Chafik, S. Strano, and J. F. Regnard Surgical Treatment of Superior Sulcus Tumors: Results and Prognostic Factors Chest, September 1, 2003; 124(3): 996 - 1003. [Abstract] [Full Text] [PDF]

				F. C. Detterbeck Changes in the treatment of Pancoast tumors Ann. Thorac. Surg., June 1, 2003; 75(6): 1990 - 1997. [Abstract] [Full Text] [PDF]

				L. Spaggiari Anterior approach versus posterior approach in apical chest tumor: surgeon's choice or oncological need? Ann. Thorac. Surg., February 1, 2003; 75(2): 633 - 634. [Full Text] [PDF]