Original article: general thoracicInduction chemoradiation compared with induction radiation for lung cancer involving the superior sulcus
Section snippets
Patients and methods
Patients with non–small-cell lung cancer invading the superior pulmonary sulcus were identified from the thoracic surgery database during a 15-year period (1985 to 2000). Only patients undergoing induction therapy followed by resection were reviewed. A retrospective chart review was performed, and the following data were recorded: patient age, sex, presence of pain pretreatment, induction treatment, adjuvant treatment, complete resection status, TNM status, length of stay, treatment-related
Results
Thirty-five patients underwent treatment of a superior sulcus tumor with induction therapy followed by resection from 1985 to 2000. Eighteen patients were men and 17 were women. All patients had mediastinoscopy before treatment, and all were found to be free of mediastinal nodal metastases. Compared with CT/RT patients, those who had induction RT were treated on average 7 years earlier, were of the same age, had less RT, were less often resected by the anterior approach, had the same rate of
Comment
The two different induction groups were fairly evenly matched for the three important prognostic factors for superior sulcus tumor patients (T and N status and complete resection) [5]. All patients were N0. The rate of complete resections was higher in the CT/RT group but not significantly (p = 0.15) so, probably owing to the small numbers of patients in the study. The number of complete resections in the CT/RT group is actually fairly high because more T4 tumors were resected. There were more
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Extended Resections for Lung Cancer
2018, IASLC Thoracic OncologySpecial types of lung cancer
2018, Lung Cancer: A Practical Approach to Evidence-Based Clinical Evaluation and ManagementManagement of Lung Cancer Invading the Superior Sulcus
2017, Thoracic Surgery ClinicsCitation Excerpt :The 2-year survival of all patients enrolled in the study was 55%.45 In 2002, Wright and colleagues46 reported the outcomes of 15 patients who underwent trimodality therapy with neoadjuvant cisplatin-based chemoradiation therapy followed by surgical resection. All patients were negative for pathologic N2 disease and 14 of 15 patients underwent complete surgical resection.
Surgical Treatment of Superior Sulcus Tumors: A 15-Year Single-center Experience
2017, Seminars in Thoracic and Cardiovascular SurgeryCitation Excerpt :Despite progress in anesthesia techniques and the management of postoperative complications, operative mortality remains high after surgery for superior sulcus NSCLC. We observed mortality rates of 9.6% and 5.3% at 90 and 30 days, respectively, which can be considered consistent with those found in the literature (ranging from 4% to 14%),9,17-24 with variability mostly related to different patient populations and taking into account the vast majority of series published to date deal with patients operated on through the classical posterior approach. Even if superior sulcus tumors are still considered a subset of aggressive NSCLC, favorable long-term results were achieved in our series: overall 2-year, 5-year, and 10-year survival rates for the whole population were 51%, 35%, and 23%, respectively.
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