Spaggiari Lorenzo, D'Aiuto Massimiliano, Veronesi Giulia, Leo Francesco, Solli Piergiorgio, Elena Leon Maria, Gasparri Roberto, Galetta Domenico, Petrella Francesco, Borri Alessandro, Scanagatta Paolo
University of Milan, School of Medicine, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
Multimed Man Cardiothorac Surg. 2007 Jan 1;2007(1018):mmcts.2005.001776. doi: 10.1510/mmcts.2005.001776.
Tumors arising anteriorly in the apex of the chest were long considered unresectable because of early invasion of vascular structures limiting radical resection through the conventional Paulson approach. These tumors became operable in 1993 when Dartevelle popularized the cervico-thoracic transclavicular technique for resecting these neoplasms. Since then several different surgical approaches to anterior Pancoast tumors have been proposed, drastically improving the rate of radical resections of these tumors. However, there is no consensus on which anterior surgical approach provides the best access to all of the apical non-small cell lung cancers of the thoracic inlet. Moreover, it is still unclear if integrated neoadjuvant and adjuvant treatments can improve the rates of complete resection, local recurrence and long-term survival.
长期以来，由于胸部尖部前方出现的肿瘤早期侵犯血管结构，限制了通过传统保尔森方法进行根治性切除，因此一直被认为无法切除。1993年，达特韦尔推广了颈胸经锁骨技术来切除这些肿瘤，这些肿瘤从此变得可手术切除。从那时起，人们提出了几种不同的手术方法来治疗前部潘科斯特肿瘤，极大地提高了这些肿瘤的根治性切除率。然而，对于哪种前部手术方法能最佳地显露胸廓入口处所有的尖部非小细胞肺癌，目前尚无共识。此外，新辅助治疗和辅助治疗相结合是否能提高完全切除率、局部复发率和长期生存率，目前仍不清楚。
