Abstract
Lung cancers arising from the extreme apex of the lung - superior sulcus tumors (SST) - have distinct symptoms and signs at presentation and a characteristic appearance on imaging. However, in their early stages, these tumors are often missed by traditional anterior/posterior chest X-rays. Recent advances in computed tomography (CT) and magnetic resonance imaging (MRI) have made selection of patients with potentially resectable of SST more accurate. If mediastinoscopy reveals no mediastinal lymph nodes involved, the patient can be treated with surgery followed by radiation therapy with or without chemotherapy. If mediastinoscopy reveals microscopic mediastinal lymph node involvement, the patient can be treated with induction radiation therapy and concurrent chemotherapy followed by surgery. If mediastinoscopy reveals gross mediastinal lymph node involvement (N2), or if CT reveals N3 or T4 lesions, the patient can be treated with concurrent chemotherapy and radiation therapy to relieve symptoms; the outcome of such treatment appears to be better than that of sequential chemotherapy followed by radiation therapy. Whenever possible, to enhance the patient's quality of life, surgery should be considered to improve function and relieve pain. (C) 2000 Wiley- Liss, Inc.
Original language | English (US) |
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Pages (from-to) | 152-164 |
Number of pages | 13 |
Journal | Seminars in Surgical Oncology |
Volume | 18 |
Issue number | 2 |
DOIs | |
State | Published - Mar 2000 |
Keywords
- Adenocarcinoma
- Antineoplastic agents
- Combined modality therapy
- Differential diagnosis
- Local neoplasm recurrence
- Lung neoplasms
- Lymphatic metastasis
- Magnetic resonance imaging
- Neoplasm staging
- Non-small-cell lung carcinoma
- Pancoast's syndrome
- Preoperative care
- Prognosis
- Radiotherapy dosage
- Survival rate
- X-ray computed tomography
ASJC Scopus subject areas
- Surgery
- Oncology