Dennis E. Johnson, MD | Authors

Management of Carcinoma of the Superior Pulmonary Sulcus

June 01, 1997

Tumors of the superior pulmonary sulcus (Pancoast tumors) are bronchogenic carcinomas that occur at the thoracic inlet and typically involve, by direct extension, the lower trunks of the brachial plexus, the intercostal nerves, the stellate ganglion, and adjacent ribs and vertebrae. These tumors are rare, comprising 5% of all lung cancers. Treatment of Pancoast tumors has traditionally consisted of preoperative radiation to a dose of 3,000 to 4,500 cGy followed by surgical resection. Overall 5-year survival rates range from 30% to 50%. Even if treatment achieves local disease control, distant failure (brain or bone) is common. Recent treatment efforts have focused on the use of induction chemoradiation followed by surgery and further chemotherapy. This combined-modality approach may become the new treatment paradigm for Pancoast tumors. [ONCOLOGY 11(6):781-785, 1997]

Role of Radiation Therapy in Retroperitoneal Sarcomas

December 01, 1996

Soft-tissue sarcomas arising from the retroperitoneum are rare tumors, and their successful treatment is problematic. This group of tumors tends to be large at presentation, and they exist in a body cavity with few fascial planes to contain them. They frequently abut vital organs or major blood vessels, which further complicates their complete removal.

Surgical Management of Pancreatic Cancer

September 01, 1996

The treatment of patients with pancreatic cancer requires the expertise of medical oncologists, radiation oncologists, radiologists, and surgical oncologists. The surgeon's role