Pancoast tumour: current therapeutic options

doi: 10.7417/CT.2019.2150

  • V. D. Palumbo Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo; - Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo
  • S. Fazzotta Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo
  • F. Fatica Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo
  • B. D’Orazio Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo
  • F. P. Caronia Mediterranean Oncological Institute (IOM), Viagrande
  • M. Cajozzo Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo
  • G. Damiano Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo
  • A. Maffongelli Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo
  • B. M. Cudia Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo
  • M. Messina School of Medicine, University of Palermo, Italy
  • A. I. Lo Monte Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo

Abstract

Background
Pancoast’s syndrome is caused by malignant neoplasm of superior sulcus of the lung which produces destructive lesions of thoracic inlet and comes along with the involvement of brachial plexus and stellate ganglion. Computed tomography (CT) or magnetic resonance imaging (MRI) scans can detect early lesions otherwise missed by routine radiographs and can also define the local extent or metastatic progression of the disease. Protocols involving combinations of irradiation, chemotherapy, and surgery are currently being under investigation to determine the best management.


Aims
This work reviewed the current diagnostic and therapeutic approaches to Pancoast’s tumors.


Discussion
Patients with lung superior sulcus carcinoma should be considered for surgery only after an appropriate diagnostic assessment. The perfect candidate for surgery should have a confined to the chest disease with T3N0M0 staging. Inoperable patient with severe pain after irradiation therapy may benefit from palliative surgical resection. Medical therapy plays only a secondary role in lung cancers, patients with disseminated lung cancer might require palliative treatment and medical management of paraneoplastic syndrome symptoms. Following surgery, radiation and chemotherapy may improve local and systemic control by addressing individual adverse findings.


Conclusions
The cooperation of surgeons, clinicians and radiologists represents the gold standard today and a multidisciplinary approach is essential to achieve the best outcome possible.
Further studies are advisable in order to define the best surgical approach and the real advantage of mini-invasive surgery by comparison with open surgery

Published
2019-07-12
How to Cite
PALUMBO, V. D. et al. Pancoast tumour: current therapeutic options. La Clinica Terapeutica, [S.l.], v. 170, n. 4, p. e291 - e294, july 2019. ISSN 1972-6007. Available at: <http://www.clinicaterapeutica.it/ojs/index.php/ClinicaTerapeutica/article/view/456>. Date accessed: 22 oct. 2019.