A Patient with D2 Lung Cancer Surviving for Nine Years following Resection and Chemotherapy

Abstract

A 64-year-old female patient underwent surgery following the discovery of a shadow, measuring 13×19 mm in the left S⁵. During thoracotomy, numerous disseminated lesions in both the visceral and parietal pleura were observed. This was classified as D2 according to the Japanese Management Code of Lung Cancer. No retention of pleural fluid was noted. The surgical stage grouping was T4N2M0, Stage IIIB. Only the tumor was resected. Histology showed the cancer to be moderately differentiated adenocarcinoma and this was also true for the disseminated lesions. After the operation, chemotherapy consisting of MMC+CPM and MMC+OK432 was administered in the thoracic cavity. Further chemotherapy such as 5-FU+MMC+Ara-C was also introduced.
CT examinations in the 6th and 7th years after operation revealed multiple nodules with a diameter of 0.3 to 0.5 cm in the periphery of the left lung. These hardly changed in size, and the patient had no evidence of distant metastases. It has been nine years since the operation was performed and she is now in Performance Status 0.
Survival for a long period is usually rare with cases of D2 lung cancer. In this case, either chemotherapy has worked very well or this is a case of adenocarcinoma with a long natural course of development. At the moment, we are trying to decide which therapy to choose in the future, taking quality of life into account.