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Journal of Surgical Oncology Aug 2017This study aims to evaluate the impact of T stage and extended surgery on the outcome of patients with Pancoast tumors after induction chemoradiation therapy.
OBJECTIVE
This study aims to evaluate the impact of T stage and extended surgery on the outcome of patients with Pancoast tumors after induction chemoradiation therapy.
METHODS
Forty-six consecutive patients who underwent chemoradiation therapy (platin-based, 45-66 Gy) followed by surgery between 1998 and 2013 were retrospectively reviewed and analyzed.
RESULTS
In 28 (61%) patients with T4 tumors, extended procedures (more than rib resection) were performed. There were 37 (80%) lobectomies, 6 (13%) pneumonectomies, and 3 (7%) sublobar resections. A total of 44 (96%) patients had R0 resection. About 30-day mortality was 0%, major surgical complications occurred in 9 (19.6%) patients. Overall survival (OS) at 5-years was 63%. Disease-free survival (DFS) at 5-years was 45%. At multivariate cox regression analysis adjusted for clinical factors, T factor (T3/T4) and extended surgical procedures did not impact survival. However, pathological positive N stage had a negative impact on OS and lack of pathological response negatively impacted both OS and DFS.
CONCLUSION
Trimodality treatment including radical resection for Pancoast tumors provides good surgical outcome and favorable long-term results. Survival of patients with T4 tumors and extended surgical procedures comparable to that of patients with T3 tumors undergoing rib resection only.
Topics: Adenocarcinoma; Adult; Aged; Chemoradiotherapy, Adjuvant; Disease-Free Survival; Female; Humans; Male; Middle Aged; Multivariate Analysis; Neoplasm Recurrence, Local; Pancoast Syndrome; Pneumonectomy; Retrospective Studies
PubMed: 28407246
DOI: 10.1002/jso.24629 -
The Annals of Thoracic Surgery Nov 2003A 48-year-old man presented with pain in his left shoulder radiating to the left scapula and a tingling sensation of the left arm with involvement of the fourth and...
A 48-year-old man presented with pain in his left shoulder radiating to the left scapula and a tingling sensation of the left arm with involvement of the fourth and fifth finger. Based on the clinical and radiologic findings, the diagnosis of Pancoast tumor of the left lung was made. Computed tomographic guided fine needle biopsy was not conclusive. A video-assisted thoracoscopic surgery was performed to obtain a biopsy. The histologic and microbiologic examinations established the diagnosis of tuberculosis (TB).
Topics: Antitubercular Agents; Biopsy, Needle; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Mycobacterium tuberculosis; Pancoast Syndrome; Radiography, Thoracic; Risk Assessment; Thoracic Surgery, Video-Assisted; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis, Pulmonary
PubMed: 14602329
DOI: 10.1016/s0003-4975(03)00656-8 -
Pain Practice : the Official Journal of... 2008The case report describes use of real-time ultrasound guidance to facilitate percutaneous ablation of cervical nerve roots in a patient with Pancoast's syndrome....
The case report describes use of real-time ultrasound guidance to facilitate percutaneous ablation of cervical nerve roots in a patient with Pancoast's syndrome. Distortion of anatomy by the tumor made it difficult to perform the procedure safely using fluoroscopy. A 64-year-old right-handed male patient with carcinoma of the left lung presented with severe pain in the left shoulder and the arm. A clinical diagnosis of the left brachial plexopathy secondary to tumor involvement of C5 to C8 nerve roots was made. Radiological appearance of the cervical spine revealed distorted anatomy because of severe degeneration of the cervical spine and guarding torticollis. Diagnostic prognostic block of the C4 to C7 exiting nerve roots was done under ultrasound guidance and resulted in more than 75% reduction in pain intensity for 4 hours. Ultrasound-guided percutaneous cervical rhizotomy was performed later. At 3-month follow-up, the patient still had complete pain relief as well as improvement in quality of sleep. Ultrasound-guided cervical nerve roots ablation is a feasible approach for patients with intractable neuropathic pain secondary to Pancoast's tumor. It can be a useful alternative to fluoroscopy in patients in whom a fluoroscopy-guided approach is deemed difficult and hazardous.
Topics: Catheter Ablation; Cervical Vertebrae; Humans; Lung Neoplasms; Male; Middle Aged; Pain; Pain Management; Pancoast Syndrome; Spinal Nerve Roots; Ultrasonics; Ultrasonography
PubMed: 18503622
DOI: 10.1111/j.1533-2500.2008.00210.x -
Cancer Bulletin (Houston, Tex.) 1955
Topics: Eponyms; Humans; Neoplasms; Pancoast Syndrome
PubMed: 13250506
DOI: No ID Found -
Cleveland Clinic Quarterly Jul 1962
Topics: Humans; Lung Neoplasms; Pancoast Syndrome; Radiation
PubMed: 13902348
DOI: 10.3949/ccjm.29.3.135 -
Pathology, Research and Practice 2007A patient presenting with Pancoast syndrome was definitely diagnosed to have pulmonary leiomyosarcoma. The patient underwent a right upper lobectomy combined with...
A patient presenting with Pancoast syndrome was definitely diagnosed to have pulmonary leiomyosarcoma. The patient underwent a right upper lobectomy combined with resection of the chest wall, including the 1st to 3rd ribs. The disease recurred rapidly at the local and distant sites. No previous reports about pulmonary sarcoma presenting as a Pancoast tumor were found in the literature. The possibility of primary pulmonary leiomyosarcoma should be considered, and early detection and surgical resection are necessary when a round or oval tumor with necrosis is observed in the apex of the lung.
Topics: Antineoplastic Agents; Fatal Outcome; Female; Humans; Leiomyosarcoma; Lung Neoplasms; Lymphatic Metastasis; Middle Aged; Necrosis; Neoplasm Invasiveness; Neoplasm Metastasis; Neoplasm Recurrence, Local; Pancoast Syndrome; Pneumonectomy; Thoracic Wall; Tomography, X-Ray Computed
PubMed: 17673374
DOI: 10.1016/j.prp.2007.06.002 -
Wiener Klinische Wochenschrift Jul 2006Long delays in diagnosis and treatment of Pancoast tumor have been reported but the reasons for these delays have yet to be fully considered. The aim of this study was...
PURPOSE
Long delays in diagnosis and treatment of Pancoast tumor have been reported but the reasons for these delays have yet to be fully considered. The aim of this study was to assess recent delays in diagnosis and treatment of Pancoast tumor and to determine the reasons for the delays.
PATIENTS AND METHODS
We identified Pancoast tumors in patients with lung cancer referred to the radiation department of a city hospital between September 1999 and August 2004. From interviews conducted by a radiation oncologist and review of the medical records, delay due to a patient was calculated as the interval between the onset of symptoms and presentation to a physician, and delay due to a doctor as the interval between the presentation and the definitive treatment. The overall treatment delay was calculated as the sum of those delays. Radiological workups were also reviewed for errors, and the effect of any errors on the delays was estimated.
RESULTS
The study population included 42 men and six women with a median age of 65.5 years at presentation. Treatment delay ranged widely from 38 to 400 days (mean 164.0): delay due to patients ranged from 0 to 371 days (mean 55.8), accounting for 34% of the mean treatment delay; delay due to doctors ranged from 14 to 349 days (mean 108.2), and accounted for the remaining (66%) mean treatment delay. In 166 radiological studies reviewed, 98 radiological errors (59%) were identified in 28 patients (58%). These patients waited an additional mean of 88.4 days for correct radiological interpretation, accounting for 48% of the mean doctors' delay. Thus, the mean doctors' delay with radiological errors was significantly longer than that without radiological errors (p < 0.05).
CONCLUSIONS
Treatment delay for Pancoast tumor was relatively long, and approximately two-thirds of the delay was due to doctors, mainly because of errors in radiology.
Topics: Aged; Diagnostic Errors; Female; Health Care Surveys; Humans; Japan; Male; Outcome Assessment, Health Care; Pancoast Syndrome; Practice Patterns, Physicians'; Radiography; Time Factors; Waiting Lists
PubMed: 16865645
DOI: 10.1007/s00508-006-0615-0 -
British Journal of Hospital Medicine Jun 1983
Comparative Study
Topics: Evaluation Studies as Topic; Humans; Pain, Intractable; Palliative Care; Pancoast Syndrome; Pneumonectomy; Preoperative Care; Radiotherapy Dosage
PubMed: 6191819
DOI: No ID Found -
The Indian Journal of Chest Diseases Apr 1969
Topics: Horner Syndrome; Humans; Male; Middle Aged; Pancoast Syndrome
PubMed: 5384100
DOI: No ID Found -
The New England Journal of Medicine Mar 1998
Topics: Biopsy, Needle; Humans; Lymph Nodes; Pancoast Syndrome
PubMed: 9499176
DOI: No ID Found