{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:19:16Z","timestamp":1761823156652},"reference-count":55,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,10]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> Non\u2014small cell lung carcinomas with spinal and brachial plexus involvement have traditionally been considered to be Stage IIIb lesions and therefore unresectable. Advances in spinal surgery, the application of magnetic resonance (MR) imaging, and improvements in neoadjuvant therapy require a reassessment of the potential for complete resection.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> The authors conducted a retrospective review of all procedures involving the resection of superior sulcus tumors with spinal or brachial plexus involvement performed between 1985 and 1999. Assessment or resectability and operative planning were based on an MR imaging classification scheme in which the extent of spinal involvement was considered. Class A tumors involved the periosteum of the vertebral body (VB) (16 patients); Class B, distal neural foramen without epidural compression (eight patients); Class C, proximal neural foramen with epidural compression (four patients); and Class D, bone involvement (VB or posterior elements) with or without epidural involvement (14 patients). Brachial plexus involvement was present in 21 patients, including 17 with T-1 nerve root only and four with C-8 or lower-trunk infiltration.<\/jats:p>\n<jats:p content-type=\"fine-print\">Complete tumor resection was achieved in 27 patients and incomplete resection in 15. Complications occurred in 14 patients, two of which were related to instrumentation failures. The overall median survival was 1.44 years. The median survival for the complete and incomplete resection groups were 2.84 and 0.79 years, respectively (p = 0.0001). There was no statistical difference in survival among classification groups.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Complete tumor resection of superior sulcus tumors is possible in selected patients in whom involvement of the spinal column and\/or brachial plexus is present. Preoperative MR imaging is essential for evaluation of the spine and surgical planning. Survival and cure are dependent on complete resection, regardless of the extent of spinal involvement.<\/jats:p>","DOI":"10.3171\/spi.2002.97.3.0301","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:54:19Z","timestamp":1241711659000},"page":"301-309","source":"Crossref","is-referenced-by-count":19,"title":["Surgical treatment of superior sulcus tumors with spinal and brachial plexus involvement"],"prefix":"10.3171","volume":"97","author":[{"given":"Mark H.","family":"Bilsky","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd W.","family":"Vitaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick J.","family":"Boland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manjit S.","family":"Bains","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viswanathan","family":"Rajaraman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie W.","family":"Rusch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Clin Oncol","doi-asserted-by":"publisher","first-page":"1880","DOI":"10.1200\/JCO.1995.13.8.1880","article-title":"Long-term survival after concurrent cisplatin\/etoposide plus chest radiotherapy followeed by surgery for stages IIIA (N2) and IIIB non-small-cell lung cancer: mature results of Southwest Oncology Group phase II study 8805.","volume":"13","author":"Albain","year":"1995"},{"key":"b2","series-title":"J Clin Oncol","doi-asserted-by":"publisher","first-page":"1880","DOI":"10.1200\/JCO.1995.13.8.1880","article-title":"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.","volume":"13","author":"Albain","year":"1995"},{"key":"b3","series-title":"J Clin Oncol","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1200\/JCO.1986.4.11.1598","article-title":"Factors affecting survival in superior sulcus tumors.","volume":"4","author":"Anderson","year":"1986"},{"key":"b4","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/S0003-4975(98)00374-9","article-title":"Superior sulcus (Pancoast) tumor: experience with 105 patients.","volume":"66","author":"Attar","year":"1998"},{"key":"b5","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1016\/S0003-4975(10)63180-3","article-title":"Pancoast's tumor: irradiation or surgery?","volume":"28","author":"Attar","year":"1979"},{"key":"b6","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2240","DOI":"10.1097\/00007632-200009010-00016","article-title":"Single-stage posterolateral transpedicle approach for spondylectomy, epidural decompression, and circumferential fusion of spinal metastases.","volume":"25","author":"Bilsky","year":"2000"},{"key":"b7","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1097\/00006123-200112000-00001","article-title":"Intralesional resections of primary and metastatic sarcoma involving the spine: outcome analysis of 59 patients.","volume":"49","author":"Bilsky","year":"2001"},{"key":"b8","series-title":"Oncologist","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1634\/theoncologist.4-6-459","article-title":"The diagnosis and treatment of metastatic spinal tumor.","volume":"4","author":"Bilsky","year":"1999"},{"key":"b9","series-title":"J Thorac Surg","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1016\/S0096-5588(20)30870-9","article-title":"Pancoast syndrome due to bronchogenic carcinoma: successful surgical removal and postoperative irradiation.","volume":"25","author":"Chardack","year":"1953"},{"key":"b10","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1227\/00006123-199301000-00001","article-title":"A systemic approach to spinal reconstruction after anterior decompression for neoplastic disease of the thoracic and lumbar spine.","volume":"32","author":"Cooper","year":"1993."},{"key":"b11","series-title":"Oncologist","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1634\/theoncologist.4-5-398","article-title":"Surgical management of superior sulcus tumors.","volume":"4","author":"Dartevelle","year":"1999."},{"key":"b12","series-title":"J Thorac Cardiovasc Surg","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1016\/S0022-5223(19)33774-2","article-title":"Anterior transcervical-thoracic approach for radical resection of lung tumors invading the thoracic inlet.","volume":"105","author":"Dartevelle","year":"1993"},{"key":"b13","series-title":"J Thorac Cardiovasc Surg","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/S0022-5223(19)34574-X","article-title":"Management of tumor adherent to the vertebral column.","volume":"97","author":"DeMeester","year":"1989"},{"key":"b14","series-title":"Chest","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1378\/chest.112.1.229","article-title":"IIB or not IIB: the current question in staging non-small cell lung cancer.","volume":"112","author":"Detterbeck","year":"1997"},{"key":"b15","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1002\/1097-0142(19860301)57:5<941::AID-CNCR2820570511>3.0.CO;2-E","article-title":"Carcinoma of the superior pulmonary sulcus treated with surgery and\/or radiation therapy.","volume":"57","author":"Devine","year":"1986"},{"key":"b16","series-title":"Ann Thorac Surg","first-page":"1788","article-title":"A multidisciplinary surgical approach to superior sulcus tumors with vertebral invasion.","volume":"68","author":"Gandhi","year":"1999"},{"key":"b17","series-title":"Semin Roentgenol","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/0037-198X(90)90037-5","article-title":"Magnetic resonance imaging in the evaluation of lung cancer.","volume":"25","author":"Gefter","year":"1990"},{"key":"b18","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1016\/0003-4975(94)90098-1","article-title":"Influence of surgical resection and brachytherapy in the management of superior sulcus tumor.","volume":"57","author":"Ginsberg","year":"1994"},{"key":"b19","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"599","DOI":"10.3171\/jns.1998.89.4.0599","article-title":"Transthoracic vertebrectomy for metastatic spinal tumors.","volume":"89","author":"Gokaslan","year":"1998"},{"key":"b20","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1016\/0003-4975(95)01099-8","article-title":"Total vertebrectomy for en bloc resection of lung cancer invading the spine.","volume":"61","author":"Grunenwald","year":"1996"},{"key":"b21","series-title":"Eur Radiol","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1007\/s003300050128","article-title":"Staging intrathoracic non-small-cell lung cancer.","volume":"7","author":"Hanson","year":"1997"},{"key":"b22","series-title":"Ann Surg Oncol","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1007\/BF02306281","article-title":"Chest wall invasive non-small cell lung cancer: patterns of failure and implications for a revised staging system.","volume":"3","author":"Harpole","year":"1996"},{"key":"b23","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1148\/radiology.170.3.2916014","article-title":"Superior sulcus tumor: CT and MR imaging.","volume":"170","author":"Heelan","year":"1989"},{"key":"b24","series-title":"J Am Stat Assoc","first-page":"57","article-title":"Nonparametric estimation from incomplete observations.","volume":"53","author":"Kaplan","year":"1958"},{"key":"b25","series-title":"Int J Radiation Oncology Biol Phys","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/0360-3016(90)90130-C","article-title":"Superior sulcus tumors: treatment selection and results for 85 patients without metastasis (Mo) at presentation.","volume":"19","author":"Komaki","year":"1990"},{"key":"b26","series-title":"Semin Surg Oncol","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1002\/(SICI)1098-2388(200003)18:2<152::AID-SSU9>3.0.CO;2-H","article-title":"The management of superior sulcus tumors.","volume":"18","author":"Komaki","year":"2000"},{"key":"b27","series-title":"Acta Radiol","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1177\/028418519103200603","article-title":"CT for predicting the resectability of lung cancer. A prospective study.","volume":"32","author":"Lahde","year":"1991"},{"key":"b28","series-title":"Mag Reson Imag","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/0730-725X(95)00011-5","article-title":"Assessment of vascular involvement with magnetic resonance angiography (MRA) in Pancoast syndrome.","volume":"13","author":"Laissy","year":"1995"},{"key":"b29","series-title":"Eur Radiol","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1007\/s003300050917","article-title":"MR imaging of the chest: mediastinum and chest wall.","volume":"9","author":"Landwehr","year":"1999."},{"key":"b30","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/0003-4975(90)90306-Q","article-title":"Can computed tomography of the chest stage lung cancer? Yes and no.","volume":"49","author":"Lewis","year":"1990"},{"key":"b31","series-title":"Brit J Hosp Med","first-page":"639","article-title":"Radiotherapy in the treatment of lung cancer.","volume":"55","author":"Macbeth","year":"1996"},{"key":"b32","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/0003-4975(94)90396-4","article-title":"Combined radiosurgical treatment of Pancoast tumor.","volume":"57","author":"Maggi","year":"1994"},{"key":"b33","series-title":"Am J Clin Oncol","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1097\/00000421-199408000-00007","article-title":"Combined treatment in superior sulcus tumors.","volume":"17","author":"Martinez-Monge","year":"1994"},{"key":"b34","series-title":"Semin Surg Oncol","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1002\/ssu.2980060505","article-title":"Surgical treatment of non-small cell lung cancer by stage.","volume":"6","author":"Martini","year":"1990"},{"key":"b35","series-title":"Thorax","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1136\/thx.52.3.284","article-title":"Pancoast tumours: clinical assessment and long term results of combined radiosurgical treatment.","volume":"52","author":"Muscolino","year":"1997"},{"key":"b36","series-title":"AJR","doi-asserted-by":"publisher","first-page":"25","DOI":"10.2214\/ajr.140.1.25","article-title":"Superior sulcus tumour: radiographic diagnosis and workup.","volume":"140","author":"O'Connell","year":"1983"},{"key":"b37","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1001\/jama.1924.02660180025007","article-title":"Importance of careful roentgen ray investigation of apical chest tumors.","volume":"83","author":"Pancoast","year":"1924"},{"key":"b38","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1001\/jama.1932.02740690001001","article-title":"Superior pulmonary sulcus tumor.","volume":"99","author":"Pancoast","year":"1932"},{"key":"b39","series-title":"Thorac Cardiovasc Surg","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1016\/S0022-5223(19)39657-6","article-title":"Carcinomas in the superior pulmonary sulcus.","volume":"70","author":"Paulson","year":"1975"},{"key":"b40","series-title":"J Thorac Cardiovasc Surg","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1067\/mtc.2001.112465","article-title":"Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus: Initial results of Southwest Oncology Group Trial 9416 (Intergroup Trial 0160).","volume":"121","author":"Rusch","year":"2001"},{"key":"b41","series-title":"J Thorac Cardiovasc Surg","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1067\/mtc.2000.106089","article-title":"Factors determining outcome after surgical resection of T3 and T4 lung cancers of the superior sulcus.","volume":"119","author":"Rusch","year":"2000"},{"key":"b42","series-title":"Lung Cancer","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/S0169-5002(97)00058-5","article-title":"Radiation therapy for stage III non-small cell lung cancer invading chest wall.","volume":"18","author":"Saito","year":"1997"},{"key":"b43","series-title":"J Thorac Cardiovasc Surg","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/S0022-5223(19)34736-1","article-title":"Carcinoma of the superior pulmonary sulcus. Results of irradiation and radical resection.","volume":"104","author":"Sartori","year":"1992"},{"key":"b44","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/S0003-4975(10)60163-4","article-title":"Pancoast tumors: improved survival with preoperative and postoperative radiotherapy.","volume":"43","author":"Shahian","year":"1987"},{"key":"b45","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1097\/00000658-196107000-00003","article-title":"Treatment of superior sulcus tumor by irradiation followed by resection.","volume":"154","author":"Shaw","year":"1961"},{"key":"b46","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1016\/S0003-4975(10)61668-2","article-title":"Influence of staging in superior sulcus (Pancoast) tumors of the lung.","volume":"29","author":"Stanford","year":"1980"},{"key":"b47","series-title":"Lung Cancer","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/S0169-5002(97)00659-4","article-title":"Superior sulcus tumor (SST): management at the institute of oncology in Ljubljana, Slovenia, 1981\u20131994.","volume":"17","author":"Strojan","year":"1997"},{"key":"b48","series-title":"Chest","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1378\/chest.93.2.275","article-title":"Ultrasonographic evaluation of pleural and chest wall invasion of lung cancer.","volume":"93","author":"Sugama","year":"1988"},{"key":"b49","series-title":"J Clin Oncol","doi-asserted-by":"publisher","first-page":"1739","DOI":"10.1200\/JCO.1987.5.11.1739","article-title":"The combined neurosurgical-thoracic management of superior sulcus tumors.","volume":"5","author":"Sundaresan","year":"1987"},{"key":"b50","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1148\/radiology.187.1.8451433","article-title":"Tumor invasion of the chest wall in lung cancer: diagnosis with US.","volume":"187","author":"Suzuki","year":"1993"},{"key":"b51","series-title":"Chest","doi-asserted-by":"publisher","first-page":"S360","DOI":"10.1378\/chest.103.4_Supplement.360S","article-title":"New approaches to Pancoast and chest wall tumors.","volume":"103","author":"Urschel","year":"1993"},{"key":"b52","series-title":"Euro J Cardiothorac Surg","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/S1010-7940(99)00102-5","article-title":"Antero-superior approaches in the practice of thoracic surgery.","volume":"15","author":"Vanakesa","year":"1999"},{"key":"b53","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1016\/S0003-4975(97)01034-5","article-title":"Anterior approaches to the thoracic spine in patients with cancer: indications and results.","volume":"64","author":"Walsh","year":"1997"},{"key":"b54","series-title":"J Thorac Cardiovasc Surg","first-page":"69","article-title":"Superior sulcus lung tumors. Results of combined treatment (irradiation and radical resection).","volume":"94","author":"Wright","year":"1987"},{"key":"b55","series-title":"J Neurosurg (Spine 1)","doi-asserted-by":"publisher","first-page":"74","DOI":"10.3171\/spi.1999.91.1.0074","article-title":"Combined chest wall resection with vertebrectomy and spinal reconstruction for the treatment of Pancoast tumors.","volume":"91","author":"York","year":"1999"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/97\/3\/article-p301.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/97\/3\/article-p301.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/97\/3\/article-p301.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T21:10:30Z","timestamp":1681593030000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/97\/3\/article-p301.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,10]]},"references-count":55,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/spi.2002.97.3.0301","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2002,10]]}}}