Superior vena cava syndrome natural history, complications and prognosis

Superior Vena Cava Syndrome Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Complications of superior vena cava syndrome include airway obstruction and increased ICP. The prognosis will vary depending on the cause of the syndrome, and the amount of blockage that has already occurred.

Complications

• The throat could become blocked, which can block the airways.
• Increased pressure may develop in the brain, leading to changed levels of consciousness, nausea, vomiting, or vision changes.

Prognosis

• The outcome varies depending on the cause and the amount of blockage.
• SVCS caused by a tumor is a sign that the tumor has spread, and it indicates a poorer long-term outlook.
• Cancer patients diagnosed with SVCS do not die of the syndrome itself but rather from the extent of their underlying disease.
• SVCS is usually a sign of locally advanced bronchogenic carcinoma. Survival depends on the status of the patient’s disease. When small cell bronchogenic carcinoma is treated with chemotherapy, the 24-month survival rate is 9% in patients without SVCS and 3% in those with the syndrome. When the malignancy is treated with radiation therapy, 46% of patients who have non-small cell lung cancer experience relief of symptoms compared with 62% of patients who have small cell bronchogenic carcinoma. The 2-year survival rate of 5% is almost the same for both groups.
• Most non-Hodgkin lymphoma patients with SVCS respond to appropriate chemotherapy or to combined modality regimens.