Routine use of staging thoracoscopy for pancoast tumors without overt radiographic chest wall invasion

Matthew O. Hubbard, Carsten Schroeder, Philip A. Linden

Research output: Contribution to journalArticle

2 Scopus citations


A retrospective review was performed of all patients with upper lobe non-small cell lung cancers to assess the use of thoracoscopy in determining chest wall invasion in patients with lung cancers abutting the first rib, but without overt radiographic invasion. Of the 12 patients with tumors abutting the first rib without overt radiographic invasion, thoracoscopy was able to correctly determine chest wall invasion in 8 patients. There was no significant morbidity related to thoracoscopy. Large tumor size did not preclude thoracoscopic staging, whereas dense adhesions did limit the use of staging thoracoscopy. Patients with invasion by thoracoscopy were able to begin radiation or chemotherapy much sooner (median 22.3 d) than patients requiring thoracotomy (median 60 d). The routine use of staging thoracoscopy in all tumors abutting the first rib without overt radiographic evidence of invasion accurately identified apical chest wall involvement in 8 of 12 patients. With this strategy, unnecessary neoadjuvant treatment and futile thoracotomy may be avoided.

Original languageEnglish (US)
Pages (from-to)111-115
Number of pages5
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Issue number2
StatePublished - Apr 1 2011
Externally publishedYes



  • chest wall
  • lung cancer
  • minimally invasive
  • staging
  • VATS

ASJC Scopus subject areas

  • Surgery

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