Surgical Approaches and Prognostic Factors in Superior Sulcus Tumors

Abstract

Objective: To evaluate surgical approaches, clinical characteristics, and prognostic factors in patients with superior sulcus tumors (SSTs) and to assess survival outcomes according to resection type.Materials and Methods: This study included 20 patients with histopathologically confirmed SSTs who underwent surgical treatment between 1997 and 2004. Eight patients were evaluated retrospectively and twelve prospectively. Demographic, clinical, radiological, histopathological, and treatment-related data were analyzed. Survival outcomes were assessed using the Kaplan–Meier method, and comparisons between groups were performed using the log-rank test.Results: All patients were male, with a mean age of 53 years. Pain was the most common presenting symptom (100%). Tumors were predominantly located in the right hemithorax (75%). Lobectomy was performed in 85% of patients, while 15% underwent wedge resection due to limited pulmonary reserve. Postoperative complications occurred in 45% of patients, with atelectasis being the most frequent. Squamous cell carcinoma was the most common histopathological subtype. Median survival was longer in the lobectomy group compared with the wedge resection group (38 vs. 14 months), although the difference did not reach statistical significance (p=0.075). Patients with nodal involvement and vertebral invasion had poorer survival.Conclusion: Extent of resection, nodal status, and local invasion remain key determinants of prognosis in SST. Lobectomy was associated with more favorable survival outcomes than limited resection, although these findings should be interpreted cautiously. Despite advances in multimodality treatment, prognostic factors continue to guide clinical decision-making in this complex disease.