Page 132 - Livre électronique des Rencontres Franco-Tunisiennes de Pneumologie 2019
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P88. MANAGEMENT OF PULMONARY SUPERIOR SULCUS TUMORS (PSST)

               BEN BDIRA B.,  FAHEM  N.,BEN  LIMEM I,MIGAOU  A.,BRAHEM Y.,BEN SAAD A.,BAILI
               H.,CHEIKH M S.,AMDOUNI N.,JLASSI O.,JOOBEUR S., ROUETBI N.

               DEPARTMENT OF PULMONOLOGY OF MONASTIR, FATTOUMA BOURGUIBA HOSPITAL ,MONASTIR ,TUNISIA


               Introduction: Pulmonary Superior Sulcus Tumors (PSST) represent 3 to 5 % of lung cancer. They
               have posed  a therapeutic challenge since their first description by Pancoast in the  early
               20thcentury. The aim of this study was to evaluate particularities of PSST and their prognostic
               factors.

               Methods: the study concerned adult patients with a confirmed diagnosis of primary PSST treated
               in the department of pulmonology of Monastir from 2002 to 2018.

               Results: there were 40 patients. The mean age was 57±12 years with male predominance (97,
               5%).95% were known smokers. Predominant symptoms were chest pain (80%) and shoulder pain
               (62,5%). chest  CT scan was performed in  all patients showing lysis of first ribs (50% cases).
               Transthoracic needle biopsy made the  diagnosis in 65% of cases. predominant types were
               adenocarcinoma (47,3%) and squamous cell carcinoma (44,3%).65% of patients were at stage IV.
               Exclusive chemotherapy was delivered to 45% of patients. 75% were treated with chemotherapy
               and radiotherapy. Only 4 patients  underwent  surgery. Median  Overall survival was
               11months.univariate analysis showed a significant variation in survival according to PS, tumor stage
               and treatment received. Multivariate analysis identified impairment in  performance status,
               smoking intoxication> 50 pack-year and absence of oncological treatment as predictive factors
               associated with mortalities.

               Conclusion: management of pulmonary superior sulcus tumors remains challenging despite recent
               advanced combined-modality therapy. An early diagnosis must be achieved.





























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