Pancoast tumour: current therapeutic options
- 1 July 2019
- journal article
- review article
- Vol. 170 (4), E291-E294
- https://doi.org/10.7417/CT.2019.2150
Abstract
Background. Pancoast's syndrome is caused by malignant neoplasm of superior sulcus of the lung which produces destructive lesions of thoracic inlet and comes along with the involvement of brachial plexus and stellate ganglion. Computed tomography (CT) or magnetic resonance imaging (MRI) scans can detect early lesions otherwise missed by routine radiographs and can also define the local extent or metastatic progression of the disease. Protocols involving combinations of irradiation, chemotherapy, and surgery are currently being under investigation to determine the best management. Aims. This work reviewed the current diagnostic and therapeutic approaches to Pancoast's tumors. Discussion. Patients with lung superior sulcus carcinoma should be considered for surgery only after an appropriate diagnostic assessment. The perfect candidate for surgery should have a confined to the chest disease with T3N0M0 staging. Inoperable patient with severe pain after irradiation therapy may benefit from palliative surgical resection. Medical therapy plays only a secondary role in lung cancers, patients with disseminated lung cancer might require palliative treatment and medical management of paraneoplastic syndrome symptoms. Following surgery, radiation and chemotherapy may improve local and systemic control by addressing individual adverse findings. Conclusions. The cooperation of surgeons, clinicians and radiologists represents the gold standard today and a multidisciplinary approach is essential to achieve the best outcome possible. Further studies are advisable in order to define the best surgical approach and the real advantage of mini-invasive surgery by comparison with open surgery.Keywords
This publication has 6 references indexed in Scilit:
- Diagnosing and treating pancoast tumorsExpert Review of Respiratory Medicine, 2016
- Video-assisted pulmonary lobectomy combined with transmanubrial approach for anterior Pancoast tumor resection: case report.Journal of Cardiothoracic Surgery, 2016
- A comparative analysis of Pancoast tumour resection performed via video-assisted thoracic surgery versus standard open approachesInteractive CardioVascular and Thoracic Surgery, 2014
- Therapeutic modalities for Pancoast tumors2014
- Routine use of Staging Thoracoscopy for Pancoast Tumors Without Overt Radiographic Chest Wall InvasionSurgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2011
- The use of video-assisted thoracic surgery in the management of Pancoast tumors☆Interactive CardioVascular and Thoracic Surgery, 2010