The combined neurosurgical-thoracic management of superior sulcus tumors.
Thirty patients with superior sulcus carcinoma were prospectively evaluated over an 18-month period. All patients underwent complete neuroradiological evaluation by computed tomography (CT) and myelography. Prior to operation, brachial plexopathy was noted in 20 patients (67%), and invasion of the spine in eight (27%). Using a team approach, gross total resection of tumor was achieved in 17 of 26 patients (65%) undergoing thoracotomy. There was no operative mortality. The use of a team approach allows extended surgical resection, especially when the spine is involved. In patients presenting with brachial plexopathy or cord compression, de novo surgery before radiation may provide better long-term palliation and pain relief.
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000601:surgery*; D000328:Adult; D000368:Aged; D001917:Brachial Plexus / Q000601:surgery; D001918:Brachytherapy; D018288:Carcinoma, Small Cell / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009192:Myelography; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D010166:Palliative Care; D010178:Pancoast Syndrome / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D013125:Spinal Neoplasms / Q000601:surgery; D014057:Tomography, X-Ray Computed