Superior vena cava syndrome revisited.

A clinical review with analysis of prognostic factors, including the impact of the initial management modality, was conducted on 137 patients with superior vena cava syndrome (SVCS) seen at the Veterans General Hospital-Taipei between 1989 and 1993. Malignant diseases account for most of the SVCS in our Chinese patients. Patients received diagnostic intervention for their underlying diseases without obvious complications. Whether or not there is a development of SVCS in lung cancer patients, showed prognostic significance in non-small cell lung cancer (NSCLC) and no significance in small cell lung cancer (SCLC). Those with SVCS as the initial manifestation of malignant disease had a poor prognosis compared to those who developed SVCS later. Survival is best in lymphoma/leukemia patients, followed by malignant thymoma and SCLC, and worst in NSCLC and metastatic cancer. The rapid onset of symptoms from SVCS had a short median survival in lung cancer and significantly compromised survival in SCLC. The overall survival of SCLC with SVCS was not affected, regardless of whether the initial therapy had been radiotherapy or chemotherapy.