A Case of Curative Resection for Non-small Cell Lung Cancer with Invasion to the Proximal Pulmonary Artery after Induction Therapy.

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  • MIYAHARA Eiji
    Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University
  • YAMASHITA Yoshinori
    Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University
  • SHIMIZU Katsuhiko
    Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University
  • HIRAI Toshihiro
    Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University
  • TOGE Tetsuya
    Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University

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  • 術前化学療法により切除しえた肺動脈浸潤肺癌の１例

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Abstract

Background: Several recent clinical studies have suggested that induction therapy can improve the histologically poor resectability and survival of patients with lung cancer in stage IIIA and IIIB. A 70-year-old man was seen at the hospital because of a cough. An abnormal shadow in the left hilus was pointed out on a chest X-ray film. Close examination showed a squamous cell carcinoma originated in the left upper lobe which invaded left pulmonary artery 1.5cm from pulmonary trunk (cT4N2M0, cStageIIIb). The patient was treated with two courses of induction chemotherapy (CDDP 80mg/m2+VDS 3.5mg/m2). Extreme reduction in size of the tumor and lymph nodse was seen with disappearance of the invasion to left pulmonary artery. Left pneumonectomy with mediastinal lymph node dissection resulted in curative resection (pT0N1M0, pStageIIa). Histologic exploration of the resected material disclosed metastasis of poorly differentiated squamous cell carcinoma to peribronchial lymph nodes and a partial involvement of tunica external of the pulmonary artery; however, there were no tumor cells in the center of the tumor foci. Histologic effect of the preoperative chemotherapy was rated Ef. 2. Postoperative course was uneventful. There has been no sign of recurrence as of 3 years after the operation. It is thought that the induction chemotherapy greatly contributes to local control of the primary foci as well as control of minute metastatic foci in the patients with far advanced non-small cell lung cancer.

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