A case of successful lobectomy in lung cancer with severe COPD

Abstract

We describe a case of lung cancer with severe chronic obstructive pulmonary disease (COPD) involving a 70-year-old man who had an adenocarcinoma of the left upper lung, and the forced expiratory volume in 1 second (FEV1) was 770 ml. The degree of his dyspnea was II based on the Hugh-Jones classification. Three weeks after the combination of pulmonary rehabilitation and Tiotropium, FEV1 improved to 810 ml. However, the predicted postoperative FEV1/predicted FEV1 was 33%. He underwent left upper lobectomy, resulting in a reduced lung volume, severe emphysema, and low blood perfusion. After the lobectomy, FEV1 was the same as the preoperative level.
Resection is possible for lung cancer patients who would be considered to have physiologically inoperable disease in combination with lung volume reduction. Forty-six months after the operation, the patient is alive and shows a favorable condition.