{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:53:47Z","timestamp":1740174827883,"version":"3.37.3"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T00:00:00Z","timestamp":1578873600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T00:00:00Z","timestamp":1578873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Chemoradiotherapy (CRT) is the standard treatment for c-stage IIIB non-small cell lung cancer (NSCLC); however, patients who respond to CRT are at risk of developing fatal complications such as massive hemoptysis or infection. In such cases, surgery is an alternative option. Currently, there are limited reports on surgery for complications arising during definitive CRT for locally advanced NSCLC. We report a case of hemoptysis after definitive CRT for c-T4N2M0 stage IIIB NSCLC that was successfully treated with lower bilobectomy combined with left atrial resection.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 72-year-old man with c-T4N2M0 stage IIIB NSCLC with left atrial invasion developed hemoptysis during CRT, which was discontinued to control hemoptysis. Chest computed tomography revealed a regressed and cavitated tumor. Three weeks after discontinuation of CRT, surgery was performed to avoid fatal complications and secure radicality. We performed lower bilobectomy combined with partial left atrial resection, which was performed using an automatic tri-stapler. The bronchial stump was covered with an omental flap. The resected specimen pathologically showed complete response with fistula between the intermediate bronchus and necrotic cavity in the tumor. His postoperative course was uneventful, and the patient was disease free at 10\u2009months after surgery.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>We successfully performed surgery after definitive CRT in a patient with c-T4N2M0 stage IIIB NSCLC. Partial left atrial resection was safely performed with an automatic tri-stapler. A complete pathological response to CRT was achieved. In a case with a chance of complete (R0) resection, when the risk of developing fatal complications might outweigh the risk of post-CRT surgery perioperative complications, surgery should be considered as a treatment option.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40792-019-0768-5","type":"journal-article","created":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T13:02:48Z","timestamp":1578920568000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgery to avoid fatal complications and secure radicality after definitive chemoradiotherapy for clinical T4N2M0 stage IIIB non-small cell lung cancer: a case report"],"prefix":"10.1186","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2858-1463","authenticated-orcid":false,"given":"Yuriko","family":"Yagi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Kodama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Momozane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukio","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Kishima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,1,13]]},"reference":[{"key":"768_CR1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/1471-2407-12-27","volume":"12","author":"M Ito","year":"2012","unstructured":"Ito M, Niho S, Nihei K, Yoh K, Ohmatsu H, Ohe Y. Risk factors associated with fatal pulmonary hemorrhage in locally advanced non-small cell lung cancer treated with chemoradiotherapy. BMC Cancer. 2012;12:27.","journal-title":"BMC Cancer"},{"key":"768_CR2","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.lungcan.2014.02.004","volume":"84","author":"H Uramoto","year":"2014","unstructured":"Uramoto H, Tanaka F. Salvage thoracic surgery in patients with primary lung cancer. Lung Cancer. 2014;84:151\u20135.","journal-title":"Lung Cancer"},{"key":"768_CR3","first-page":"1","volume":"10","author":"C Dickhoff","year":"2018","unstructured":"Dickhoff C, Otten RHJ, Heymans MH, Dahel M. Salvage surgery for recurrent or persistent tumour after radical (chemo) radiotherapy for locally advanced non-small cell lung cancer: a systematic review. Ther Adv Med Oncol. 2018;10:1\u201312.","journal-title":"Ther Adv Med Oncol"},{"key":"768_CR4","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1067\/mtc.2001.116472","volume":"122","author":"DH Grunenwald","year":"2001","unstructured":"Grunenwald DH, Andre F, Pechoux CL, Girard P, Lamer C, Laplanche A, et al. Benefit of surgery after chemoradiotherapy in stage IIIB (T4 and\/or N3) non-small cell lung cancer. J Thorac Cardiovasc Surg. 2001;122:796\u2013802.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"768_CR5","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.athoracsur.2004.06.100","volume":"79","author":"L Spaggiari","year":"2005","unstructured":"Spaggiari L, D' Aiuto M, Veronesi G, Pelosi G, de Pas T, Catalano G, et al. Extended pneumonectomy with partial resection of the left atrium, without cardiopulmonary bypass for lung cancer. Ann Thorac Surg. 2005;79:234\u201340.","journal-title":"Ann Thorac Surg"},{"key":"768_CR6","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1016\/j.athoracsur.2013.12.086","volume":"97","author":"G Galvaing","year":"2014","unstructured":"Galvaing G, Tardy MM, Cassagnes L, Da Costa V, Chadeyras JB, Naamee A, et al. Left atrial resection for T4 lung cancer without cardiopulmonary bypass: technical aspects and outcomes. Ann Thorac Surg. 2014;97:1708\u201314.","journal-title":"Ann Thorac Surg"},{"key":"768_CR7","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1007\/s00268-008-9873-5","volume":"33","author":"L Wu","year":"2009","unstructured":"Wu L, Xu Z, Zhao X, Li J, Zhong L, Pang T, et al. Surgical treatment of lung cancer invading the left atrium or base of the pulmonary vein. World J Surg. 2009;33:492\u20136.","journal-title":"World J Surg"},{"key":"768_CR8","first-page":"423","volume":"69","author":"Y Tunezuka","year":"2016","unstructured":"Tunezuka Y, Tanaka N, Fujimori H. Extended right pneumonectomy with partial resection of the left atrium without cardiopulmonary bypass. Kyobu Geka. 2016;69:423\u20137. (in Japanese)","journal-title":"Kyobu Geka"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-019-0768-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s40792-019-0768-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-019-0768-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T01:16:51Z","timestamp":1610414211000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-019-0768-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,13]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["768"],"URL":"https:\/\/doi.org\/10.1186\/s40792-019-0768-5","relation":{},"ISSN":["2198-7793"],"issn-type":[{"type":"electronic","value":"2198-7793"}],"subject":[],"published":{"date-parts":[[2020,1,13]]},"assertion":[{"value":"10 October 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 December 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent for publication has been obtained from the patient presented in this report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16"}}