de Perrot M, Licker M, Robert J, Spiliopoulos A
Unité de chirurgie thoracique, Hôpitaux Universitaires de Genève.
Schweiz Med Wochenschr. 1998 Oct 10;128(41):1548-52.
Although the treatment of Pancoast tumours usually combines radiotherapy and surgery, poor prognosis has been reported. The influence of clinical signs and extension of surgical resection on long-term survival has not yet been systematically investigated.
Between 1977 and 1997, among 1129 patients operated consecutively in our institution for a bronchogenic carcinoma, 14 (1.2%) presented a Pancoast tumour. Delay between the onset of symptoms and definite diagnosis ranged from 1 to 14 months (median 7 months). A complete surgical resection was performed in 7 patients, 6 of whom did not have mediastinal lymph node metastasis. Radiotherapy or radiochemotherapy was performed in all patients.
Overall 5-year survival rate is 36%. However, 5-year survival rate increases up to 60% if the diagnosis is established within 6 months after the onset of symptoms, and up to 67% if the tumour has been removed without mediastinal lymph node metastasis. In contrast, the 5-year survival rate decreases to 20% or 0% respectively, if symptoms last more than 6 months, or if tumoral resection is incomplete.
The incidence of Pancoast tumours compared to other bronchogenic carcinomas is low. An early diagnosis allows complete resection of the tumour and contributes to improve survival.
尽管肺上沟瘤的治疗通常结合放疗和手术，但仍有报道称其预后较差。临床体征和手术切除范围对长期生存的影响尚未得到系统研究。
1977年至1997年间，在我们机构连续接受手术治疗的1129例支气管肺癌患者中，有14例（1.2%）表现为肺上沟瘤。症状出现至明确诊断的延迟时间为1至14个月（中位时间7个月）。7例患者进行了完整的手术切除，其中6例没有纵隔淋巴结转移。所有患者均接受了放疗或放化疗。
总体5年生存率为36%。然而，如果在症状出现后6个月内确诊，5年生存率可提高至60%；如果肿瘤在无纵隔淋巴结转移的情况下被切除，5年生存率可提高至67%。相反，如果症状持续超过6个月，或肿瘤切除不完全，5年生存率分别降至20%或0%。
与其他支气管肺癌相比，肺上沟瘤的发病率较低。早期诊断可实现肿瘤的完整切除，并有助于提高生存率。
