Surgery for Superior Sulcus Tumor, Partially Using a Robotic Approach, After Neoadjuvant Nivolumab With Platinum-Based Chemotherapy

Superior sulcus tumors have traditionally been treated with concurrent chemoradiotherapy followed by surgical resection, although radiation-induced fibrosis complicates surgery. Recent studies suggest that neoadjuvant nivolumab combined with platinum-based chemotherapy improves prognosis while limiting perioperative complications. We successfully performed surgical resection of a superior sulcus tumor by using a hybrid approach: an L-shaped incision for chest wall resection and a robotic-assisted technique for left upper lobectomy and lymphadenectomy. The patient achieved a major pathologic response with an uneventful recovery. This case highlights the potential of neoadjuvant immunochemotherapy and robotic surgery in optimizing outcomes for superior sulcus tumor management.