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The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 69-74, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
CD Wright, AC Moncure, JA Shepard, EW Wilkins Jr, DJ Mathisen and HC Grillo
Twenty-one patients underwent combined therapy (irradiation and radical
resection) for a Pancoast tumor at the Massachusetts General Hospital
between 1976 and 1985. All patients underwent en bloc removal of the apical
chest wall and underlying lung. In addition four patients required
subclavian artery resection, and in five patients a portion of the
vertebral body was resected. There were three operative deaths. Median
survival was 24 months and actuarial survival rate was 55% at 3 years and
27% at 5 years. Long-term palliation of pain was achieved in 72% of the
patients. Involvement of the subclavian artery, vertebral body, or rib did
not preclude long-term survival. Computed tomographic scanning in these
patients is often indeterminate regarding invasion of chest wall structures
but is more helpful than plain films alone. When compared to recent series
in which irradiation alone was used, the combined approach appears to
produce better results.
ARTICLES
Superior sulcus lung tumors. Results of combined treatment (irradiation and radical resection)
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