Abstract

Treatment modalities of the superior sulcus tumours remain controversial. This study aims to investigate factors influencing survival in surgically treated superior sulcus tumours. Thirty-one cases of surgically treated superior sulcus tumours between 1994 and 2001 were retrospectively reviewed in terms of their demographic and clinical features, treatment modalities, and survival. All patients were male with a mean age of 52±9 (range, 32-73). Twelve (39%) patients underwent surgery following radiotherapy while remaining 19 (61%) were treated with surgery alone. Lobectomy was performed in 25 (81%) of cases, and wedge resection in 6 (19%). Pathological staging was T3N0 in 20, T3N2 in 3, T3N3 in 1, T4N0 in 5 and T4N2 in 2 cases. Complete resection rate was 92% in cases who underwent surgery following radiotherapy, whereas this was only 68% in surgery alone group (p=0.1). Overall median survival was 20 months, 2 and 4 year survival rates were 40% and 15%, respectively. Median survival was 42 months in preoperative radiotherapy group and 13 months in surgery alone group (p=0.22). Negative prognostic factors included incomplete resection (p =0.01), type of resection (p=0.02), invasion of subclavian artery (p=0.01) or vertebrae (p=0.03). Mediastinal lymph node involvement (p=0.2), invasion of brachial plexus (p=0.1) or subclavian vein (p=0.19) affected outcome adversely though the differences did not reach statistical significance. The morbidity and mortality rates were 29% and 9.7%, respectively. The optimal treatment for superior sulcus tumor is surgery following preoperative radiotherapy. Both the chance of complete resection and survival rate were increased by preoperative radiotherapy but the differences did not reach statistical significance.