Results of surgical resection after induction chemoradiation for Pancoast tumours †

Interactive Cardiovascular and Thoracic Surgery
Giuseppe MarulliF Rea

Abstract

Pancoast tumour is a rare neoplasia in which the optimal therapeutic management is still controversial. The traditional treatment of Pancoast tumour (surgery, radiotherapy or a combination of both) have led to an unsatisfactory outcome due to the high rate of incomplete resection and the lack of local and systemic control. The aim of the study was to determine the efficacy of the trimodality approach. Fifty-six patients (male/female ratio: 47/9, median age: 64 years) in stage IIB to IIIB were treated during a period between 1994 and 2013. Induction therapy consisted of 2-3 cycles of a platinum-based chemotherapy associated with radiotherapy (30-44 Gy). After restaging, eligible patients underwent surgery 2 to 4-week post-radiation. Thirty-two (57.1%) patients were cT3 and 24 (42.9%) cT4, 47 (83.9%) were N0 and 9 (16.1%) N+. Forty-eight (85.7%) patients underwent R0 resection and 10 (17.9%) had a complete pathological response (CPR). Thirty-day mortality rate was 5.4%, major surgical complications occurred in 6 (10.7%) patients. At the end of the follow-up, 17 (30.4%) patients were alive and 39 (69.6%) died (29 for cancer-related causes), with an overall 5-year survival of 38%. At statistical analysis, stage IIB (P = 0.003), R0 ...Continue Reading

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Citations

Jul 2, 2016·Interactive Cardiovascular and Thoracic Surgery·Silviu I BuderiSteven Woolley
Apr 14, 2017·Journal of Surgical Oncology·Ryuichi WasedaWalter Klepetko
Apr 2, 2017·Thoracic Surgery Clinics·Johannes R KratzDavid M Jablons
Jan 29, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Shinsuke UchidaShun-Ichi Watanabe
Mar 4, 2020·General Thoracic and Cardiovascular Surgery·Yoshihisa ShimadaNorihiko Ikeda
Jul 24, 2018·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Lary A RobinsonFrank Vrionis

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