208 results match your criteria: "Pancoast Tumor* Thoracic Surgery"

Current management of anterior Pancoast tumors.

JTCVS Tech

June 2024

Departments of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, Hôpital Marie-Lannelongue, Le Plessis Robinson, France.

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Objectives: Current National Comprehensive Cancer Network guidelines recommend definitive chemoradiation rather than surgery for patients with locally advanced clinical stage T3 and N2 (stage IIIB) lung cancer involving the chest wall. The data supporting this recommendation are controversial. We studied whether surgery confers a survival advantage over definitive chemoradiation in the National Cancer Database.

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Article Synopsis
  • The text describes a complex robotic-assisted surgery to remove a right posterior Pancoast tumor using the DaVinci X system, involving multiple surgical ports.
  • The procedure involved lobectomy, rib resection, and extensive dissection around the thoracic area, ultimately requiring a small thoracotomy to complete tumor removal due to its invasion into surrounding structures.
  • Post-surgery, the patient had a smooth recovery and was discharged after 5 days, with the tumor confirmed as squamous non-small-cell lung cancer; however, a year later, an asymptomatic recurrence was addressed with radiotherapy.
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Chest wall resections for sulcus superior tumors.

J Thorac Dis

February 2024

Department of Cardiothoracic Surgery, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Article Synopsis
  • Chemoradiotherapy followed by surgical resection is the standard treatment for superior sulcus tumors (SST), which invade the chest wall and often require complex surgical techniques.
  • The surgery for SST is challenging due to higher risks of complications, the tumor's anatomical location, and potential variations in surgical approach, highlighting the importance of careful patient selection and multidisciplinary care.
  • Advancements in surgical techniques, including minimally invasive options and 3D imaging, are evolving to enhance recovery and reduce morbidity, while chest wall reconstruction, when needed, should use appropriate materials for structural support.
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Article Synopsis
  • The gold standard treatment for Pancoast tumors involves neoadjuvant chemoradiation followed by radical resection of the upper lobe and chest wall.
  • Traditional surgical approaches, like the extended posterolateral thoracotomy, can cause significant tissue damage and may not optimize tumor exposure, leading to newer techniques being explored.
  • This report describes a pioneering case of fully portal robotic-assisted Pancoast tumor resection, highlighting its safety and improved exposure compared to traditional methods.
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A superior pulmonary sulcus tumor, also known as a Pancoast tumor, invades tissues or organs at the entrance of the thorax, such as the brachial plexus, upper ribs, vertebrae, subclavian vessels and stellate ganglia. Induction concurrent chemoradiotherapy followed by radical surgical resection is the preferred treatment. The present study reported the case of a 52-year-old male who presented at Hubei Cancer Hospital, Tongji Medical College (Wuhan, Hubei) with left chest pain and an abnormal chest computed tomography scan showing a mass of 81x43 mm in the left upper chest wall that invaded the first, second and third anterior ribs.

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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.

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Pancoast tumors, also defined as superior sulcus tumors, still represent a complex clinical condition requiring high technical surgical skills within more articulated multimodality treatment. The morbidity and mortality rates after Pancoast tumor treatments range from 10 to 55% and 0 to 7%, respectively, and the 5-year survival rate has significantly improved in recent years thanks to the advancement of treatments. Although a multimodality approach combining chemotherapy, radiotherapy, and surgery allows for radical resection and effective local control in the vast majority of patients, many patients cannot receive surgical resection or complete the whole programmed therapeutic regimen.

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Background: Pancoast tumors represent 5% of non-small cell lung cancers. Complete surgical resection and no lymph node involvement are important positive prognostic factors. Previous literature has identified neoadjuvant chemoradiation treatment, followed by surgical resection, as the standard of care.

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Objectives: Superior sulcus tumour, which affects the lung's apex, is an uncommon subtype of non-small cell lung cancer (NSCLC). The current study examined the clinical characteristics and management of superior sulcus NSCLC patients in a high-volume referral oncological centre over 22 years.

Methods: Retrospective review of 100 surgeries with curative intent for superior sulcus NSCLC over 22 years (July 1998 - December 2020).

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Influence of anterior tumor location on survival after resection of lung cancer invading the thoracic inlet (Pancoast tumors).

J Thorac Cardiovasc Surg

May 2023

Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Article Synopsis
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Anatomic evaluation of Pancoast tumors using three-dimensional models for surgical strategy development.

J Thorac Cardiovasc Surg

March 2023

Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada. Electronic address:

Objective: Pancoast tumor resection planning requires precise interpretation of 2-dimensional images. We hypothesized that patient-specific 3-dimensional reconstructions, providing intuitive views of anatomy, would enable superior anatomic assessment.

Methods: Cross-sectional images from 9 patients with representative Pancoast tumors, selected from an institutional database, were randomly assigned to presentation as 2-dimensional images, 3-dimensional virtual reconstruction, or 3-dimensional physical reconstruction.

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Article Synopsis
  • Surgical treatment of superior sulcus tumors (SSTs) is difficult, with definitive chemoradiotherapy (CRT) being the standard approach, often supplemented by surgery in experienced centers.
  • Immune checkpoint inhibitors (ICIs) are emerging treatments, and ongoing studies are exploring their effectiveness after CRT, particularly in patients with unresectable local advanced non-small cell lung cancer (NSCLC).
  • A case report discusses a patient with an advanced SST who successfully underwent salvage surgery after CRT combined with the ICI durvalumab, providing insights into the clinical and pathological outcomes of such treatments.
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Long-term outcomes after chest wall resection and repair with titanium bars and sternal plates.

Front Surg

September 2022

Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Université Paris-Saclay, International Center for Thoracic Cancers, Marie-Lannelongue Hospital, GHPSJ, Le Plessis Robinson, France.

Article Synopsis
  • En-bloc complete resection is the preferred method for treating localized chest wall tumors, with titanium bar reconstruction showing good early results but limited long-term data available.
  • A study reviewed 68 patients from 2012 to 2018 who had CW tumor resections and titanium repairs, achieving a 94% complete resection rate and tracking survival outcomes over time.
  • Results indicated that there were decent survival rates at 1, 3, and 5 years, with some complications including surgical site infections and chronic pain, but no reports of titanium allergy or flail chest.
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Article Synopsis
  • - A 73-year-old man with lung cancer underwent a thoracoscopic procedure to remove a tumor in the right upper lung and the chest wall, measuring 48 mm and located between ribs 1 and 3.
  • - The surgery involved carefully separating the ribs and using an 8 cm incision for access, allowing for the complete removal of the tumor and surrounding tissues.
  • - This minimally invasive thoracoscopic method is suggested as a less painful alternative to traditional surgical techniques, potentially improving patient recovery and shoulder function.
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Hybrid robotic lobectomy with thoracic wall resection for superior sulcus tumor.

Gen Thorac Cardiovasc Surg

August 2022

Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3 Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan.

A major challenge in treating superior sulcus tumors is achieving complete surgical resection because of technical difficulties associated with the anatomical structures and approaches to the thorax. Our technique combines posterior minimally invasive thoracotomy with robot-assisted right upper lobectomy, thereby reducing the invasiveness of the surgical approach and postoperative complications, including wound pain. In the presented case, the tumor was located on the apical right upper lobe, directly invading the apical thoracic wall structures.

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Study Design: Retrospective cohort study.

Purpose: This study aimed to evaluate the outcomes of patients who had T4 Pancoast tumors invading the spine and underwent en bloc resection and spinal stabilization through a single-stage posterior approach.

Overview Of Literature: Surgical resection for Pancoast tumors affecting the spine has been successfully performed in two stages involving spinal reconstruction and tumor resection.

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Lung autotransplantation with ex vivo bench surgery is a useful surgical technique for centrally located and locally advanced lung cancer to spare lung parenchyma by avoiding pneumonectomy. Here, we present a patient with a bulky superior sulcus tumor with hilar involvement for which lung-sparing complete resection was achieved with autotransplantation. After concurrent chemoradiotherapy, en bloc resection, consisting left pneumonectomy combined with apical chest wall resection (1-4 ribs), back-table extended double-sleeve resection after lung preservation, and reimplantation of basal segment was performed.

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Superior pulmonary sulcus tumor is a cancer arising in the apex of the lung that with potential invasion of the brachial plexus, upper ribs, vertebrae, subclavian vessels, and stellate ganglion. Induction concurrent chemoradiotherapy followed by radical surgical resection with lobectomy combined with any structures in the thoracic inlet invaded by tumor and thorough mediastinal lymph node dissection is the preferred treatment. Both anterior and posterior approaches are applied for resection.

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Introduction: and importance: Pneumonectomy is commonly associated with cardiopulmonary complications. Pneumonectomy in Pancoast tumor with mediastinal extension and no metastasis could be successful and efficient.

Case Presentation: Herein, we report a successful pneumonectomy of a 54-year-old man with pancoast tumor along with the involvement of mediastinal space including right hilum of the lung, right bronchial, inferior vena cava vein and pericardium.

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Background: Superior sulcus tumors, or Pancoast tumors, are challenging thoracic malignancies to treat due to their anatomical location posing difficult surgical access and potential involvement of adjacent vital structures. The current standard of care is trimodality treatment, which consists of induction chemoradiotherapy followed by radical surgical resection. This study aims to report the clinical outcomes of trimodality approach in British Columbia, Canada.

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A rare case of chordoma presenting as a Pancoast tumor.

Rare Tumors

July 2021

Department of Hematology/Oncology, White River Health System, Batesville, AR, USA.

The notochord is the defining structure of all chordate embryos. It is a midline structure ventral to the ectoderm, neural plates, and neural arch. Remnants of the notochord ultimately give rise to the nucleus pulposus.

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Objective: To analyse the malignant chest wall tumors in terms of histological types and confer option for resection, stabilisation and reconstruction, along with postoperative morbidity and mortality.

Study Design: Observational study.

Place And Duration Of Study: Department of Thoracic Surgery, CMH Rawalpindi, Lahore and Multan from January, 2010 to October, 2018.

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Background: Pancoast tumors are a wide range of tumors located in the apex of the lung. Traditional surgery for Pancoast neurogenic tumors frequently involves extensive approaches, whether anterior or posterior or a combination, in which osteotomies are sometimes required. In this study, the authors proposed a less invasive surgical strategy using the standard Cloward's approach for complete resection of a schwannoma arising from the T1 nerve root.

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