[Primary pulmonary carcinoma and Pancoast syndrome].
BACKGROUND
Although the treatment of Pancoast tumours usually combines radiotherapy and surgery, poor prognosis has been reported. The influence of clinical signs and extension of surgical resection on long-term survival has not yet been systematically investigated.


METHODS
Between 1977 and 1997, among 1129 patients operated consecutively in our institution for a bronchogenic carcinoma, 14 (1.2%) presented a Pancoast tumour. Delay between the onset of symptoms and definite diagnosis ranged from 1 to 14 months (median 7 months). A complete surgical resection was performed in 7 patients, 6 of whom did not have mediastinal lymph node metastasis. Radiotherapy or radiochemotherapy was performed in all patients.


RESULTS
Overall 5-year survival rate is 36%. However, 5-year survival rate increases up to 60% if the diagnosis is established within 6 months after the onset of symptoms, and up to 67% if the tumour has been removed without mediastinal lymph node metastasis. In contrast, the 5-year survival rate decreases to 20% or 0% respectively, if symptoms last more than 6 months, or if tumoral resection is incomplete.


CONCLUSIONS
The incidence of Pancoast tumours compared to other bronchogenic carcinomas is low. An early diagnosis allows complete resection of the tumour and contributes to improve survival.
de Perrot
M
M
Unité de chirurgie thoracique, Hôpitaux Universitaires de Genève.
Licker
M
M
Robert
J
J
Spiliopoulos
A
A
D000328:Adult; D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010178:Pancoast Syndrome / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011013:Pneumonectomy; D015996:Survival Rate
Carcinomes pulmonaires primitifs et syndrôme de Pancoast.