Abstract
Background: This study aims to investigate the treatment modalities and factors influencing survival
in surgically treated superior sulcus tumors. Patients and Method: Sixty-five cases of surgically treated non-small cell carcinoma of the lung occurring
as superior sulcus tumors between 1994 and 2007 were retrospectively reviewed. Twenty-five
patients underwent induction radiotherapy (RT), 10 had induction chemoradiotherapy
(CT/RT). In thirty patients surgery was performed directly. The mortality rate was
6.2 %. Pathological stage was T3 in 55, T4 in 10, N0 in 52, and N1 in 5 and N2 in
8 patients. Results: Overall 5- and 10-year survival rates were 31 % and 28 %, respectively. Complete
resection rate was 90 % for patients who received induction CT/RT and 80 % for patients
who either received induction RT alone or patients in whom surgery was performed directly.
In patients who received neoadjuvant therapy with complete tumor resection, the median
survival time was 33 months (28 months for patients who received induction RT alone
and 36 months for patients who received induction CT/RT), and the 5-year survival
rate was 41 %. Median survival time and 5-year survival rate of patients treated by
direct surgery with complete resection was 24 months and 37 %, respectively (p = 0.87). Five-year survival and 10-year survival rates were significantly higher
after complete resection than after incomplete resection (38 % and 34 % vs. 0 %, p = 0.0001). In multivariate analysis, only N2 disease (p = 0.04) and incomplete resection (p = 0.03) were found to be poor prognostic factors. Conclusion: The presence of N2 disease and incomplete resection are the two most important factors
affecting survival. Induction CT/RT may increase the ability to achieve complete surgical
resection.
Key words
thoracic surgery - superior sulcus tumour - induction chemoradiation therapy - surgery
- NSCLC
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Dr. MD Adalet Demir
Department of Thoracic Surgery Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery
Yüzyýl mah. Kýþla Cad. Yeþil zengibar sitesi A-3, Blok D:9 Baðcýlar
34000 Istanbul
Turkey
Telefon: + 90 21 50 52 41 44 19
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eMail: dradalet@hotmail.com