- 期刊
Successful Treatment of Synchronous Solitary Ipsilateral Axillary Lymph Node Metastasis from Non-Small Cell Lung Cancer with Radical Resection and Perioperative Chemotherapy
經根除性手術合併手術前後化學治療成功之非小細胞肺癌併同側腋下淋巴節同時性單一轉移
摘要
肺癌位居全世界癌症死亡原因之第一位。約60%非小細胞肺癌病患診斷時已發生轉移。轉移性非小細胞肺癌病患未治療的中位數存活期僅約3至4個月。即使標靶治療用於部分具有突變基因的病患可延長總存活期至12個月甚至更長，但多數起初對於標靶治療有反應的病患最終疾病仍惡化。另一方面，部分研究指出手術切除轉移病灶對於單一腦部或腎上腺轉移的病患可能達成長期存活。但對於其它位置單一轉移的病患，轉移病灶切除的效果很少被提及。我們在這裡提出一個非小細胞肺癌合併同時性單一腋下淋巴節轉移的臨床案例。經同時手術切除原發性肺腫瘤及轉移病灶後，這個案例達到延長的無疾病存活。目前針對非小細胞肺癌原發處可切除但併有單一遠端淋巴節轉移的最佳治療策略尚未確定。轉移病灶切除配合原發肺腫瘤手術有機會延長此類病患的存活期。
並列摘要
Lung cancer is the leading cause of death from cancer worldwide. Almost 60% of patients with non-small cell lung cancer present with metastasis at the time of diagnosis. Without treatment, the median survival for patients with metastatic non-small cell lung cancer is only 3-4 months. While targeted therapy has improved median overall survival to 12 months and even longer in patients with driver mutations, most patients with initial response to targeted agents ultimately develop disease progression. On the other hand, several studies have shown resection of solitary brain or adrenal metastases may achieve long-term survival in selected patients. However, in patients with solitary extra-cranial, extra-adrenal metastases, the results of metastasectomy have rarely been reported. Herein, we report a case of synchronous solitary axillary lymph node metastasis from non-small cell lung cancer. Surgical resection of both the primary lung tumor and metastasis combined with perioperative chemotherapy achieved prolonged disease- free survival in this case. To date, the optimal treatment strategy for patients with solitary distant lymph node metastases and resectable primary lung tumors has not been established. The addition of metastasectomy to primary lung cancer surgery may provide a chance for long-term survival for such patients.
延伸閱讀
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