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P1.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 206)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
P1.01-025 - Radical Resection for Supraclavicular Lymph Node Metastasis (N3-Stage IIIB) Adenocarcinoma of the Lung (ID 1672)
09:30 - 17:00 | Author(s): X. Qiu
In China, lung cancer is increasing rapidly, of which 80% are non-small cell lung cancer, and most belong to Stage IIIB and IV when diagnosed, losing opportunity of surgery, and the prognosis is worse, the average survival time is about 6-12 months. Recently we perform radical resection for part N3-Stage IIIB non-small cell lung cancer, hope to improve the prognosis of these patients. A typical case is discussed here.
Case1: Man, aged 43 in Dec 2012, found right supraclavicular lymph node swollen, CT showed right lower lobe tumor 7X6X5cm3, invading right inferior pulmonary vein and pericardium, regional and mediastinal lymph node 11,10,7,4R,3,2R,1R swollen badly; right supraclavicular lymph node biopsy revealed the diagnosis of lung adenocarcinoma; no other distant metastasis was found in brain, liver, and bone; cT3-4N3M0 Stage IIIB, which is usually contraindication of surgery. Three cycles’ preoperative chemotherapy of Pemetrexed and cisplatin (DDP) was conducted, the lung tumor shrunk 1/3, mediastinal lymph node shrunk significantly, and the right supraclavicular lymph node disappeared. PET-CT showed right lower lobe tumor and part mediastinal lymph node positive, however, showed negative in the neck and other part of the body; cT2aN1-2M0 Stage IIA-IIIA, prepared for operation.
Standard “large-incision” right posterolateral thoracotomy was performed, pleural adhesion, tissue edema, fragile, easily broken, easy bleeding were encountered. Right lower lobe lobectomy, systematic lymph node dissection including No.2R,3A,3P,4R,7,9,10,11,12 group lymph node and surrounding adipose tissue were en block dissected. Tumor size 4X4X3cm3, postoperative pathology diagnosed as lung adenocarcinoma, No.12 lymph node metastasis, others were negative, pT2aN1M0 Stage IIA. Two cycles’ postoperative chemotherapy was followed. Regular follow-up showed the patient recovered very well. Now he is in his 3rd year postoperatively, living a healthy man’s life. CT, Ultrasound, ECT, and blood tumor markers’ test showed no sign of recurrence and metastasis.
Part supraclavicular lymph node metastasis N3-Stage IIIB non-small cell lung cancer, if prepared carefully, could gain the opportunity of receiving surgical resection, could achieve a much more better prognosis, even to get cured as usual Stage IA-IIIA lung cancer patients who receive regular radical resection of lung cancer.