Trimodality therapy for superior sulcus tumour

experience of a single institution over 19 years

Shinsuke Uchida, Yukihiro Yoshida, Yuichiro Ohe, Yuko Nakayama, Noriko Motoi, Aki Kobayashi, Keisuke Asakura, Kazuo Nakagawa, Shun Ichi Watanabe

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Induction chemoradiotherapy followed by surgery is the standard treatment for superior sulcus tumours (SSTs). However, the protocols, chemotherapy agents and cycles used as well as the mode and intensity of radiotherapy vary between institutions. Thus, the objective of the study was to investigate the effects of trimodality therapy on the outcomes of patients with SSTs. METHODS: Sixty patients with SSTs were enrolled between January 1999 and December 2017. Induction therapy consisted primarily of 2 cycles of mitomycin-vindesine-cisplatin or cisplatin-vinorelbine delivered concurrently to the tumour with 40-45 Gy of radiation. Surgery was performed 2-6 weeks after completion of induction therapy. RESULTS: Fifty-four (90%) patients underwent radical surgical resection. Complete pathological resection was achieved in 44 patients (81%). There was no 30-day mortality. After a median follow-up of 57.0 months, 19 (35%) patients experienced recurrence, and 8 (15%) patients showed brain metastasis. A pathological complete response (PCR) was observed in 12 (22%) patients. The 5-year survival rate for the entire population (n = 54) was 69% (95% confidence interval 55-81%). The survival rate was better for patients who underwent complete resection than for those who underwent incomplete resection (73% vs 51%, P = 0.46). A better survival rate was evident in patients with PCR than in those without PCR (92% vs 62%, P = 0.12). CONCLUSIONS: Trimodality therapy for SSTs was efficacious and associated with favourable outcomes, with acceptable morbidity and mortality. PCR in patients with resected SSTs reveals promising long-term survival prospects with the trimodality therapy.

Original languageEnglish
Pages (from-to)167-173
Number of pages7
JournalEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
Volume56
Issue number1
DOIs
Publication statusPublished - 2019 Jul 1
Externally publishedYes

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Neoplasms
Therapeutics
Survival Rate
Cisplatin
Vindesine
Mortality
Mitomycin
Chemoradiotherapy
Radiotherapy
Confidence Intervals
Radiation
Neoplasm Metastasis
Morbidity
Recurrence
Drug Therapy
Survival
Brain
Population

Keywords

  • Pathological complete response
  • Superior sulcus tumour
  • Trimodality therapy

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Trimodality therapy for superior sulcus tumour : experience of a single institution over 19 years. / Uchida, Shinsuke; Yoshida, Yukihiro; Ohe, Yuichiro; Nakayama, Yuko; Motoi, Noriko; Kobayashi, Aki; Asakura, Keisuke; Nakagawa, Kazuo; Watanabe, Shun Ichi.

In: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, Vol. 56, No. 1, 01.07.2019, p. 167-173.

Research output: Contribution to journalArticle

Uchida, Shinsuke ; Yoshida, Yukihiro ; Ohe, Yuichiro ; Nakayama, Yuko ; Motoi, Noriko ; Kobayashi, Aki ; Asakura, Keisuke ; Nakagawa, Kazuo ; Watanabe, Shun Ichi. / Trimodality therapy for superior sulcus tumour : experience of a single institution over 19 years. In: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2019 ; Vol. 56, No. 1. pp. 167-173.
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abstract = "OBJECTIVES: Induction chemoradiotherapy followed by surgery is the standard treatment for superior sulcus tumours (SSTs). However, the protocols, chemotherapy agents and cycles used as well as the mode and intensity of radiotherapy vary between institutions. Thus, the objective of the study was to investigate the effects of trimodality therapy on the outcomes of patients with SSTs. METHODS: Sixty patients with SSTs were enrolled between January 1999 and December 2017. Induction therapy consisted primarily of 2 cycles of mitomycin-vindesine-cisplatin or cisplatin-vinorelbine delivered concurrently to the tumour with 40-45 Gy of radiation. Surgery was performed 2-6 weeks after completion of induction therapy. RESULTS: Fifty-four (90{\%}) patients underwent radical surgical resection. Complete pathological resection was achieved in 44 patients (81{\%}). There was no 30-day mortality. After a median follow-up of 57.0 months, 19 (35{\%}) patients experienced recurrence, and 8 (15{\%}) patients showed brain metastasis. A pathological complete response (PCR) was observed in 12 (22{\%}) patients. The 5-year survival rate for the entire population (n = 54) was 69{\%} (95{\%} confidence interval 55-81{\%}). The survival rate was better for patients who underwent complete resection than for those who underwent incomplete resection (73{\%} vs 51{\%}, P = 0.46). A better survival rate was evident in patients with PCR than in those without PCR (92{\%} vs 62{\%}, P = 0.12). CONCLUSIONS: Trimodality therapy for SSTs was efficacious and associated with favourable outcomes, with acceptable morbidity and mortality. PCR in patients with resected SSTs reveals promising long-term survival prospects with the trimodality therapy.",
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AU - Uchida, Shinsuke

AU - Yoshida, Yukihiro

AU - Ohe, Yuichiro

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AU - Motoi, Noriko

AU - Kobayashi, Aki

AU - Asakura, Keisuke

AU - Nakagawa, Kazuo

AU - Watanabe, Shun Ichi

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N2 - OBJECTIVES: Induction chemoradiotherapy followed by surgery is the standard treatment for superior sulcus tumours (SSTs). However, the protocols, chemotherapy agents and cycles used as well as the mode and intensity of radiotherapy vary between institutions. Thus, the objective of the study was to investigate the effects of trimodality therapy on the outcomes of patients with SSTs. METHODS: Sixty patients with SSTs were enrolled between January 1999 and December 2017. Induction therapy consisted primarily of 2 cycles of mitomycin-vindesine-cisplatin or cisplatin-vinorelbine delivered concurrently to the tumour with 40-45 Gy of radiation. Surgery was performed 2-6 weeks after completion of induction therapy. RESULTS: Fifty-four (90%) patients underwent radical surgical resection. Complete pathological resection was achieved in 44 patients (81%). There was no 30-day mortality. After a median follow-up of 57.0 months, 19 (35%) patients experienced recurrence, and 8 (15%) patients showed brain metastasis. A pathological complete response (PCR) was observed in 12 (22%) patients. The 5-year survival rate for the entire population (n = 54) was 69% (95% confidence interval 55-81%). The survival rate was better for patients who underwent complete resection than for those who underwent incomplete resection (73% vs 51%, P = 0.46). A better survival rate was evident in patients with PCR than in those without PCR (92% vs 62%, P = 0.12). CONCLUSIONS: Trimodality therapy for SSTs was efficacious and associated with favourable outcomes, with acceptable morbidity and mortality. PCR in patients with resected SSTs reveals promising long-term survival prospects with the trimodality therapy.

AB - OBJECTIVES: Induction chemoradiotherapy followed by surgery is the standard treatment for superior sulcus tumours (SSTs). However, the protocols, chemotherapy agents and cycles used as well as the mode and intensity of radiotherapy vary between institutions. Thus, the objective of the study was to investigate the effects of trimodality therapy on the outcomes of patients with SSTs. METHODS: Sixty patients with SSTs were enrolled between January 1999 and December 2017. Induction therapy consisted primarily of 2 cycles of mitomycin-vindesine-cisplatin or cisplatin-vinorelbine delivered concurrently to the tumour with 40-45 Gy of radiation. Surgery was performed 2-6 weeks after completion of induction therapy. RESULTS: Fifty-four (90%) patients underwent radical surgical resection. Complete pathological resection was achieved in 44 patients (81%). There was no 30-day mortality. After a median follow-up of 57.0 months, 19 (35%) patients experienced recurrence, and 8 (15%) patients showed brain metastasis. A pathological complete response (PCR) was observed in 12 (22%) patients. The 5-year survival rate for the entire population (n = 54) was 69% (95% confidence interval 55-81%). The survival rate was better for patients who underwent complete resection than for those who underwent incomplete resection (73% vs 51%, P = 0.46). A better survival rate was evident in patients with PCR than in those without PCR (92% vs 62%, P = 0.12). CONCLUSIONS: Trimodality therapy for SSTs was efficacious and associated with favourable outcomes, with acceptable morbidity and mortality. PCR in patients with resected SSTs reveals promising long-term survival prospects with the trimodality therapy.

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