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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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