Early results of a trimodality treatment for superior sulcus tumors.
BACKGROUND
Superior sulcus tumors are a unique form of lung cancer. Preoperative concurrent radio- and chemotherapy improves the results of treating these lung tumors.


OBJECTIVE
The study aimed to assess the early results of a trimodality treatment for superior sulcus tumors.


METHODS
Fifty-six superior sulcus tumors patients were operated on between 2006 and 2013. Data from 25 patients undergoing preoperative chemoradiotherapy were analyzed. Fifteen men and 10 women were treated (mean age: 59 years). All patients experienced pain in the pectoral girdle of the chest.


RESULTS
Nineteen patients received preoperative chemoradiotherapy consisting of 2 chemotherapy cycles with cisplatin (a different number of cycles was administered in 6 cases) and irradiation at a mean dose of 51.2 Gy (30-60 Gy) in 25 fractions (25-30 fractions). All patients underwent upper lobectomy. Twenty-two patients underwent chest wall resection, whereas 3 patients underwent extrapleural excision of the infiltrate without rib resection. Stages IIB and IIIB were diagnosed in 15 and 10 patients, respectively. In 9 samples, no neoplastic features were found, 9 showed individual neoplastic lesions, and in 7 most tumor cells were necrotized. The R1 resection was noted in 2 patients. Mean hospitalization time was 13 days. No perioperative deaths were noted.


CONCLUSIONS
The trimodality treatment for superior sulcus tumors is a safe method. Perioperative mortality and the number of complications observed among patients treated with this method are similar to those observed in one-phase surgery. In over half of the patients, chemoradiotherapy resulted in complete or nearly complete remission of the neoplasm.
Department of Thoracic Surgery, Medical University of Gdansk, Poland.
Mariusz
M
Łapiński
Department of Oncology and Radiotherapy, Medical University of Gdansk, Poland.
Rafał
R
Dziadziuszko
Chair and Clinic of Anesthesiology and Intensive Care, Medical University of Gdansk, Poland.
Wioletta
W
Sawicka
Department of Thoracic Surgery, Medical University of Gdansk, Poland.
Witold
W
Rzyman
lung cancer; superior sulcus tumor