Non-small cell lung carcinoma of the superior sulcus: The evolution of treatment outcomes with multimodality treatment at a single institution.

Objectives: We evaluated the efficacy of the multimodality approach in treating superior sulcus non-small cell lung carcinoma (SS NSCLC).

Methods: We retrospectively analyzed the records of 57 patients with SS NSCLC who were treated at our institution between 1982 and 2007.

Results: During the study period, 3- and 5-year survival increased significantly from 42.6% and 42.6% in the first half of the study period (1982-1994) to 72.7% and 65.4% in the second half (1995-2007), respectively. Methods of clinical staging were unchanged between the two time periods, although the ratio of adenocarcinoma was increased, and multimodality treatment, particularly concurrent chemoradiotherapy followed by surgical resection, was used more frequently in the second half of the study period. The 5-year survival of patients who received preoperative chemoradiotherapy followed by surgery (n = 27) was better than that of those who received other treatment regimen with surgery (n = 22, 64.6% vs. 49.6%; P = 0.044). Five-year survival in patients with complete resection after chemoradiotherapy was 70.4%. Thirteen patients (48%) achieved a pathologic complete response or minimal microscopic disease.

Conclusions: Multimodality treatment with concurrent chemoradiotherapy followed by surgery appears to contribute to improved outcomes over time in patients with SS NSCLC.