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中华胸部外科电子杂志 ›› 2022, Vol. 09 ›› Issue (03) : 168 -172. doi: 10.3877/cma.j.issn.2095-8773.2022.03.07

肺上沟瘤或侵犯胸壁的T3期肺癌外科治疗

肺上沟瘤的外科治疗进展
许林1,()   
  1. 1. 210009 南京,江苏省肿瘤医院胸外科
  • 收稿日期:2022-08-05 修回日期:2022-08-24 接受日期:2022-08-25 出版日期:2022-08-28
  • 通信作者: 许林

Progress in surgical treatment of superior sulcus tumors

Lin Xu1,()   

  1. 1. Department of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing 210009, China
  • Received:2022-08-05 Revised:2022-08-24 Accepted:2022-08-25 Published:2022-08-28
  • Corresponding author: Lin Xu
引用本文:

许林. 肺上沟瘤的外科治疗进展[J]. 中华胸部外科电子杂志, 2022, 09(03): 168-172.

Lin Xu. Progress in surgical treatment of superior sulcus tumors[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2022, 09(03): 168-172.

肺上沟瘤(Pancoast瘤)的广义概念是肺尖部的任何病变(原发性恶性肿瘤、转移肿瘤、良性肿瘤等)压迫或侵犯了C8、T1神经根、交感神经链、星状神经节,而产生Pancoast综合征。肺上沟瘤的狭义概念特指原发在肺尖部的支气管肺癌,其是非小细胞肺癌(NSCLC)的一种少见的临床亚型,经常侵犯肋骨、锁骨下血管、神经等胸廓入口结构。狭义的肺上沟瘤是本文主要的研究对象。肺上沟瘤从最初的无法治疗,发展到现在的放疗、化疗和手术的多学科治疗,治疗效果有了显著提升。近几十年来,肺上沟瘤的手术路径、手术方式也在不断迭代中,外科治疗方式的进展显著改善了肺上沟瘤患者的长期生存。本文就肺上沟瘤的治疗,特别是外科治疗的进展进行述评,为肺上沟瘤的治疗提供较为全面的参考。

Superior sulcus tumor is considered as any lesion, including primary malignant tumor, metastatic tumor, benign tumor, etc., typically invading the C8 or T1 nerve roots, sympathetic nerve chain and stellate ganglion. A distinct clinical presentation now commonly referred to as Pancoast syndrome, which is classified as a relatively rare clinical subtype of non-small cell lung cancer (NSCLC) , and the thoracic inlet such as ribs, subclavian vessels, and nerves could also be invaded. From untreatable to the present multidisciplinary treatments of radiotherapy, chemotherapy and surgery, the therapeutic effect has been significantly improved. In recent decades, surgical approaches have been advanced, which has significantly improved the long-term survival of patients with superior sulcus tumors. This article reviews the treatment of superior sulcus tumor, especially the progress of surgical treatment, and provides a more comprehensive reference for clinical treatment of superior sulcus tumor.

1
Arcasoy SMJett JR.Superior pulmonary sulcus tumors and Pancoast’s syndrome[J].N Engl J Med1997337(19):1370-1376.
2
Chardack WMMaccallum JD.Pancoast tumor; five-year survival without recurrence or metastases following radical resection and postoperative irradiation[J].J Thorac Surg195631(5):535-542.
3
Shaw RRPaulson DLKee JL.Treatment of Superior Sulcus Tumor by Irradiation Followed by Resection[J].Ann Surg1961154(1):29-40.
4
Niwa HMasaoka AYamakawa Y,et al.Surgical therapy for apical invasive lung cancer: different approaches according to tumor location[J].Lung Cancer199310(1-2):63-71.
5
Masaoka AIto YYasumitsu T.Anterior approach for tumor of the superior sulcus[J].J Thorac Cardiovasc Surg197978(3):413-415.
6
Dartevelle PGChapelier ARMacchiarini P,et al.Anterior transcervical-thoracic approach for radical resection of lung tumors invading the thoracic inlet[J].J Thorac Cardiovasc Surg1993105(6):1025-1034.
7
Grunenwald DSpaggiari L.Transmanubrial osteomuscular sparing approach for apical chest tumors[J].Ann Thorac Surg199763(2):563-566.
8
Bains MSGinsberg RJJones WG 2nd,et al.The clamshell incision: an improved approach to bilateral pulmonary and mediastinal tumor[J].Ann Thorac Surg199458(1):30-32.
9
Rusca MCarbognani PBobbio P.Cervicothoracic tumors: results of resection by the "hemi-clamshell" approach[J].J Thorac Cardiovasc Surg1999117(5):1040.
10
Rusch VW.Management of Pancoast tumours[J].Lancet Oncol20067(12):997-1005.
11
Donington JVaillères EBains M,et al.Management of the Apical Tumor: May 4, 2013, Minneapolis, MN[J].Semin Thorac Cardiovasc Surg201325(3):256-271.
12
Cheung IHLim E.Video-assisted thoracoscopic surgical lobectomy with limited en bloc resection of superior sulcus tumor[J].J Thorac Cardiovasc Surg2012144(6):e148-e151.
13
Oka SOno KKajiyam K,et al.A minimally invasive and safe surgical approach to resect anterior superior sulcus tumors[J].Int J Surg Case Rep202068:148-150.
14
Uchida SSuzuki KFukui M,et al.Hybrid robotic lobectomy with thoracic wall resection for superior sulcus tumor[J].Gen Thorac Cardiovasc Surg202270(8):756-758.
15
Mariolo AVCasiraghi MGaletta D,et al.Robotic Hybrid Approach for an Anterior Pancoast Tumor in a Severely Obese Patient[J].Ann Thorac Surg2018106(3):e115-e116.
16
朱鸿宇,李明.机器人手术系统在胸部肿瘤手术中的应用[J].中国肿瘤外科杂志202113(6):529-535.
17
Herbut PAWatson JS.Tumor of the thoracic inlet producing the Pancoast syndrome; a report of 17 cases and a review of the literature[J].Arch Pathol (Chic)194642:88-103.
18
Walker JE.Superior sulcus pulmonary tumor (Pancoast syndrome)[J].J Med Assoc Ga194635(12):364.
19
Shahian DMNeptune WBEllis FH Jr.Pancoast tumors: improved survival with preoperative and postoperative radiotherapy[J].Ann Thorac Surg198743(1):32-38.
20
Sartori FRea FCalabrò F,et al.Carcinoma of the superior pulmonary sulcus. Results of irradiation and radical resection[J].J Thorac Cardiovasc Surg1992104(3):679-683.
21
Ginsberg RJMartini NZaman M,et al.Influence of surgical resection and brachytherapy in the management of superior sulcus tumor[J].Ann Thorac Surg199457(6):1440-1445.
22
Albain KSRusch VWCrowley JJ,et al.Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA(N2) and IIIB non-small-cell lung cancer: mature results of Southwest Oncology Group phase II study 8805[J].J Clin Oncol199513(8):1880-1892.
23
Rusch VWGiroux DJKraut MJ,et al.Induction chemoradiation and surgical resection for superior sulcus non-small-cell lung carcinomas: long-term results of Southwest Oncology Group Trial 9416(Intergroup Trial 0160)[J].J Clin Oncol200725(3):313-318.
24
Kunitoh HKato HTsuboi M,et al.Phase II trial of preoperative chemoradiotherapy followed by surgical resection in patients with superior sulcus non-small-cell lung cancers: report of Japan Clinical Oncology Group trial 9806[J].J Clin Oncol200826(4):644-649.
25
Gomez DRCox JDRoth JA,et al.A prospective phase 2 study of surgery followed by chemotherapy and radiation for superior sulcus tumors[J].Cancer2012118(2):444-451.
26
Ramalingam SSVansteenkiste JPlanchard D,et al.Overall Survival with Osimertinib in Untreated, EGFR-Mutated Advanced NSCLC[J].N Engl J Med2020382(1):41-50.
27
Hayashi HSugawara SFukuda Y,et al.A Randomized Phase II Study Comparing Nivolumab with Carboplatin-Pemetrexed for EGFR-Mutated NSCLC with Resistance to EGFR Tyrosine Kinase Inhibitors(WJOG8515L)[J].Clin Cancer Res202228(5):893-902.
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