title: Surgical treatment of superior sulcus tumors.
abstract: OBJECTIVE
  To access the clinical outcome of patients with superior sulcus tumor.
  
  
  METHODS
  We reviewed the records of 16 patients who underwent surgery for a superior sulcus tumor between 1988 and 2003, focusing on the type of surgery.
  
  
  RESULTS
  All 16 patients underwent en bloc lung and chest wall resection, which was done as pneumonectomy in 1 patient and lobectomy in 15. Complete resection was achieved in 11 patients, but incomplete resection was done in 5 patients because microscopic examination revealed positive surgical margins. Eight patients underwent partial vertebrectomy and 1 patient had combined resection of the subclavian artery. There was no postoperative mortality. All patients received pre- or postoperative adjuvant therapy, or both. The overall 5-year survival rate was 31.0%. The 5-year survival rate was higher after complete resection than after incomplete resection (59.3% vs 0%, P = 0.08). Patients who underwent complete resection for vertebral invasion and those who did not had 5-year survival rates of 66.7% and 0%, respectively (P = 0.17). Patients who underwent preoperative induction therapy followed by complete resection and those who did not had 5-year survival rates of 80% and 0%, respectively (P = 0.009).
  
  
  CONCLUSIONS
  Although superior sulcus tumors are still complex, preoperative induction therapy followed by complete resection seemed effective for prolonging survival.
authors.affiliation: Department of Surgery II, Division of Thoracic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Koizumi
authors.forename: Shuji
authors.initials: S
authors.lastname: Haraguchi
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hirata
authors.forename: Kyoji
authors.initials: K
authors.lastname: Hirai
authors.forename: Iwao
authors.initials: I
authors.lastname: Mikami
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamagishi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Okada
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010178:Pancoast Syndrome / Q000473:pathology / Q000601:surgery; D011013:Pneumonectomy; D015996:Survival Rate; D016896:Treatment Outcome