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Superior sulcus non-small cell lung cancers (Pancoast tumors): Current outcomes after multidisciplinary management.
McLaughlin, Kaitlin; Tan, Kay See; Dycoco, Joe; Chen, Monica F; Chaft, Jamie E; Mankuzhy, Nikhil P; Rimner, Andreas; Aly, Rania G; Fanaroff, Rachel E; Travis, William D; Bilsky, Mark; Bains, Manjit; Downey, Robert; Huang, James; Isbell, James M; Molena, Daniela; Park, Bernard J; Jones, David R; Rusch, Valerie W.
Afiliación
  • McLaughlin K; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Tan KS; Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Dycoco J; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Chen MF; Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Chaft JE; Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Mankuzhy NP; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Rimner A; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Aly RG; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Fanaroff RE; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Travis WD; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Bilsky M; Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Bains M; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Downey R; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Huang J; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Isbell JM; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Molena D; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Park BJ; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Jones DR; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
  • Rusch VW; Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: ruschv@mskcc.org.
J Thorac Cardiovasc Surg ; 166(6): 1477-1487.e8, 2023 12.
Article en En | MEDLINE | ID: mdl-37611845
OBJECTIVE: Despite neoadjuvant chemoradiotherapy, Pancoast tumors still present surgical and oncologic challenges. To optimize outcomes, we used a multidisciplinary care paradigm with medical and radiation oncology, and involvement of spine neurosurgery for most T3 and all T4 tumors. Spine neurosurgery permitted resection of transverse process for T3 and vertebral body resection for T4 tumors. METHODS: Retrospective analysis of single institution, prospective database of patients undergoing resection for cT3 4M0 Pancoast tumors. Patients were grouped as cT3 with combined resection with spine neurosurgery (T3 Neuro), cT3 without spine neurosurgery (T3 NoNeuro), and cT4. Overall survival, progression-free survival were analyzed by Kaplan-Meier and compared between groups using log-rank test. Cumulative incidence of local-regional and distant recurrence were compared using Gray test. P value <.05 was considered significant. RESULTS: From 2000 to 2021, 155 patients underwent surgery: median age was 58 years, and 81 were (52%) men. Most patients received neoadjuvant platinum-based neoadjuvant chemoradiotherapy (n = 127 [82%]). Operations were 48 cT3 Neuro, 41 cT3 NoNeuro, 66 cT4. R0 resection was achieved in 49 (94%) cT3 NoNeuro, 35 (85%) cT3 Neuro, and 57 (86%) cT4 patients (P = .4). Complete or major pathologic response occurred in 71 (55%) patients. Lower local-regional cumulative incidence was seen in cT3 Neuro versus cT3 NoNeuro (P = .05) and after major pathologic response. Overall survival and progression-free survival were associated with complete response, pathologic stage, and nodal status but not cT category. CONCLUSIONS: This treatment paradigm was associated with a high frequency of R0 resection, complete response, and major pathologic response. cT3 and cT4 tumors had similar outcomes. Novel therapies are needed to improve complete response.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares Límite: Female / Humans / Male / Middle aged Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos