title: [A radical resection of non-small cell lung cancer invading chest wall with ipsilateral axillary lymph node metastases].
abstract: A 41-year-old man who had non-small cell lung cancer invading his right 3rd, 4th and 5th ribs with hilum lymph node swelling(cT3N1M0, cStage III A), received chemoradiation therapy, cisplatin(CDDP)/docetaxel, and 2 Gy/Fr of irradiation prior to surgery. But the therapy was discontinued due to interstitial pneumonitis on day 24, during 28 Gy of radiation. At that time, a PET-CT scan revealed the accumulation of FDG in the primary tumor, hilar lymph node, and one of the ipsilateral axillar lymph nodes, in which cancer cell presence was proven by aspiration needle cytology. We organized a radical operation even though the node status was classified to cStage IV, because ipsilateral axillary lymph nodes may be regarded as regional nodes for tumors invading the chest wall. Right upper lobectomy and chest wall resection were performed, and the ipsilateral hilar, mediastinal, and axillary lymphnode were dissected. Pathological findings showed no active cancer cell in the primary lesion and hilar lymph nodes(Ef. 3), but obvious metastasis in one of the axillary lymph nodes(pT0N0M1b, pStage IV). The patient received adjuvant chemotherapy(CDDP/vinorelbine), and is alive and tumor-free 10months after the resection.
authors.affiliation: Dept. of Surgery, Toyonaka Municipal Hospital.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Watanabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwazawa
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kitahara
authors.forename: Takehiro
authors.initials: T
authors.lastname: Yanagawa
authors.forename: Koji
authors.initials: K
authors.lastname: Munakata
authors.forename: Kaori
authors.initials: K
authors.lastname: Takamoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nagai
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyake
authors.forename: Taishi
authors.initials: T
authors.lastname: Hata
authors.forename: Kenshu
authors.initials: K
authors.lastname: Kawanishi
authors.forename: Junzo
authors.initials: J
authors.lastname: Shimizu
authors.forename: Kimimasa
authors.initials: K
authors.lastname: Ikeda
authors.forename: Jyunya
authors.initials: J
authors.lastname: Fujita
authors.forename: Kenzou
authors.initials: K
authors.lastname: Akagi
authors.forename: Keizou
authors.initials: K
authors.lastname: Dono
authors.forename: Masashi
authors.initials: M
authors.lastname: Kitada
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takimoto
authors.forename: Kinya
authors.initials: K
authors.lastname: Abe
authors.forename: Shiro
authors.initials: S
authors.lastname: Adachi
authors.forename: Takashi
authors.initials: T
authors.lastname: Shimano
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001365:Axilla; D001706:Biopsy; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use; D035441:Thoracic Wall / Q000473:pathology*; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077235:Vinorelbine
chemical_list: D011838:Radiation-Sensitizing Agents; D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine