SUPERIOR VENA-CAVA SYNDROME REVISITED

A clinical review with analysis of prognostic factors, including the i mpact of the initial management modality, was conducted on 137 patient s with superior vena cave syndrome (SVCS) seen at the Veterans General Hospital-Taipei between 1989 and 1993. Malignant diseases account for most of the SVCS in our Chinese patients. Patients received diagnosti c intervention for their underlying diseases without obvious complicat ions. Whether or not there is a development of SVCS in lung cancer pat ients; showed prognostic significance in non-small cell lung cancer (N SCLC) and no significance in small cell lung cancer (SCLC). Those with SVCS as the initial manifestation of malignant disease had a poor pro gnosis compared to those who developed SVCS later. Survival is best in lymphoma/leukemia patients, followed by malignant thymoma and SCLC, a nd worst in NSCLC and metastatic cancer. The rapid onset of symptoms f rom SVCS had a short median survival in lung cancer and significantly compromised survival in SCLC. The overall survival of SCLC with SVCS w as not affected, regardless of whether the initial therapy had been ra diotherapy or chemotherapy.