title: [Outcome of surgical treatment for Pancoast lung carcinoma in Iceland].
abstract: Pancoast tumors are lung carcinomas that invade the apical chest wall and surrounding structures. Treatment is complex and often involves surgery together with radio- and chemotherapy. We studied the outcome of surgical resection for Pancoast tumors in Iceland.
  
  
  
  A retrospective study including all patients that underwent resection of a Pancoast tumor with curative intent in Iceland in the years 1991-2010. Data on symptoms, complications, TNM-stage, relapse and survival were analyzed.
  
  
  
  Twelve patients were operated on; 7 on the right lung. Shoulder pain (n=5) and/or chest pain (n=3), cough (n=6) and weight loss (n=5) were the most common presenting symptoms. Adenocarcinoma (n=5) and squamous cell carcinoma (n=4) were the most frequent histological types. Average tumor size was 5,9 cm (range: 2,8-15). Five cases were stage IIB and 7 stage IIIA according to operative staging. In 10 cases (83%) the surgical margins were free of tumor. All patients survived surgery and only one patient suffered a major operative complication, an intraoperative bleeding. In one case induction chemo-radiation prior to surgery was administrated, and 8 patients received postoperative radiotherapy. Recurrent disease was diagnosed in 9 patients; four had local or regional recurrence, four had distant metastases and one patient was diagnosed with both local and distant recurrences simultaneously. Survival at 5 years was 33% and median survival was 27,5 months (range: 4-181).
  
  
  
  Operative and short-term outcomes for patients with Pancoast tumors in Iceland are excellent. However, long-term outcomes are not as favorable and recurrence rate is high compared to other studies, possibly due to incomplete preoperative staging and less use of chemo-radiation therapy prior to surgery among these patients.
authors.forename: Björn Már
authors.initials: BM
authors.lastname: Fridriksson
authors.forename: Steinn
authors.initials: S
authors.lastname: Jónsson
authors.forename: Gudrún Nína
authors.initials: GN
authors.lastname: Oskarsdottir
authors.forename: Andri Wilberg
authors.initials: AW
authors.lastname: Orrason
authors.forename: Helgi J
authors.initials: HJ
authors.lastname: Ísaksson
authors.forename: Tomas
authors.initials: T
authors.lastname: Gudbjartsson
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D059186:Chemoradiotherapy, Adjuvant; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010178:Pancoast Syndrome / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden