title: Evaluation of arm function and quality of life after trimodality treatment for superior sulcus tumours.
abstract: OBJECTIVE
  Following trimodality treatment for superior sulcus tumours (SSTs), the 5-year survival rate has significantly improved. Quality of life and potential negative effects of this strategy have become more important. The objective of this study was to investigate the quality of life and the arm and shoulder function after the resection of superior sulcus tumours following neoadjuvant chemoradiation.
  
  
  METHODS
  Patients were selected from a thoracic surgery database. Between January 2002 and December 2010, 72 patients received trimodality treatment of whom 39 were alive at the start of this study in 2010. The following arm function tests were used: nine-hole peg test, range of motion test and action research arm test. Quality of life was assessed using the Disability of the arm and shoulder and SF-36 questionnaires. Analyses of the arm function were conducted comparing the treated side with the untreated side. For quality of life, patients treated on their dominant side were compared with those treated on their non-dominant side.
  
  
  RESULTS
  In total, 19 patients participated in this study (15 men and 4 women). The median age was 59 years (range 39-73), median radiation dose 50 Gy (range 39-66) and median follow-up 40 months (range 4-101). There was no statistically significant difference in arm and shoulder function between the treated and the untreated arm. However, statistically significantly less pain was found if patients were treated on their dominant side.
  
  
  CONCLUSIONS
  After the resection of SSTs following chemoradiotherapy, the arm and shoulder function on the affected side is comparable with the functions at the contralateral side. Patients treated for an SST on their dominant side are less affected in their quality of life regarding pain compared with those treated on their non-dominant side.
authors.affiliation: Department of Surgery,  VU University Medical Center, Amsterdam,  Netherlands.
authors.forename: Ramon R
authors.initials: RR
authors.lastname: Gorter
authors.forename: Cornelis G
authors.initials: CG
authors.lastname: Vos
authors.forename: Janine
authors.initials: J
authors.lastname: Halmans
authors.forename: Koen J
authors.initials: KJ
authors.lastname: Hartemink
authors.forename: Marinus A
authors.initials: MA
authors.lastname: Paul
authors.forename: Jan Wolter A
authors.initials: JW
authors.lastname: Oosterhuis
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects; D004185:Disability Evaluation; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D010178:Pancoast Syndrome / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D010808:Physical Examination; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*