Triple promary lung cancers with impaired pulmonary function; a case report.

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Recently we operated on a patient with triple primary lung cancers : adenocarcinoma in left S1+2a and squamous cell carcinomas at the ostium of left B3 and at the spur between right B2 and B3. The patient also had impaired pulmonary function, VC 2.1l (63%), FEV 1.0 0.7l (40 %), RV 4.6l (74%), VO2max 408 ml/min and VO2/VE 20 ml/l. On the basis of these results bilateral upper lobectomies were judged to be impossible. Upper left lobectomy and limited radiation to the right lung were planned. After the operation marked dyspnea on light exercise continued and his ECOG performance status scale was grade four for more than half a year. Limited radiation was applied about 12 months after surgery, but his respiratory function deteriorated and he died. There are many studies correlating preoperative respiratory function and postoperative complications, but there has been no precise description of the limit of lung resection. We conclude that this patient illustrates the limit of pulmonary resection.
特定非営利活動法人日本呼吸器外科学会の論文