Pancoast tumor: surgical management

Résumé fourni par la source

Pancoast tumor are rare condition. They represent less than 5% of bronchopulmonary cancers. Surgery is the cornerstone of treatment, especially after induction chemotherapy, and has proven to be effective in terms of prognosis and recurrence-free survival. Patients and methods: This is a retrospective study including patients operated for Pancoast tumor in our institution between 2010 and 2020. Results: We collected 13 cases. The mean age of the patients was 57 years, men and smokers. The symptomatology was dominated by chest pain associated to a progressive deterioration of the general state. Four patients had arm or shoulder pain. Twenty-three percent of the cases had hemoptysis. The average time from onset of symptoms to diagnosis was 5 months. Radiological findings showed an apical lung tumor with bony involvement. Bronchial endoscopy was normal. Fifteen percent had received induction chemotherapy. The surgical approach was a posterolateral thoracotomy (61.5%), Paulson approach (30.7%) and hemiclamshell incision(7.8%). All patients had en bloc resection of the tumor associated with had chest wall reconstruction in 3 cases. The postoperative course was uneventful in 30.7% of cases. Postoperative complications were dominated by atelectasis (38%) and pneumonia (46%). One patient had prolonged air-leak. One patient died at Day 36 from septic shock. Thirty-eight percent of patients had adjuvant radio-chemotherapy. In a period of 3 years, no patient presented a recurrence. Conclusion: Pancoast tumors are rare and insidious in evolution. Their management is always a challenge. Surgery, when it is possible, is the preferred approach. It is a heavy surgery with a significant morbidity but it improves considerably the survival.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.