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Lung Cancer

After lung cancer surgery, how can we prevent recurrence and metastasis? This method can help understand

时间:2026-04-22 人气:

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Disease Overview


 
In 2017, Mr. Liu underwent a CT scan and discovered a nodule in the lower lobe of his right lung, measuring approximately 7mm*8mm. He was advised to follow up without undergoing treatment.
In September 2020, a follow-up CT scan revealed an irregular mass shadow in the basal segment of the lower lobe of the right lung, measuring 24mm*19mm. The possibility of peripheral lung cancer could not be ruled out; carcinoembryonic antigen (CEA) levels were elevated. For further treatment, VATS resection of the lower lobe of the right lung and mediastinal lymph node dissection (with nerve preservation) were performed in September 2020.
Microscopically, the specimen (from the lower lobe of the right lung) showed a malignant tumor arranged in adenoid and cribriform patterns, accompanied by necrosis. The tumor measured 2cm*1.5cm*1cm, was closely adjacent to the pleura, and showed no intravascular tumor thrombus or nerve invasion. No metastatic cancer was found in the lymph nodes.
Department
   
Pu    
Small
Knowledge

Knowledge


 
Video-Assisted Thoracoscopic Surgery (VATS)  
 

Video-assisted thoracoscopic surgery (VATS) is a newly developed minimally invasive diagnostic and therapeutic method in the field of thoracic surgery. It is favored by doctors and patients due to its advantages of minimal trauma, mild pain, rapid recovery, and minimal impact on cardiopulmonary function. Modern endoscopic surgery integrates electronic digital imaging technology and information technology with traditional surgical medicine, representing a novel surgical technique.

It is like a large camera, capable of inserting a cylindrical lens with a diameter of 1.0 cm into the chest cavity. Through a miniature imaging system, the adjacent tissues and morphological structures of human organs are transmitted to the monitor screen in images. Surgeons insert endoscopic instruments through button-sized incisions to dissect and separate tissues, completing the surgery.

The greatest advantage of the thoracoscopic system lies in its minimal trauma. Without the need for a chest retractor to rigidly open the intercostal space, the intercostal nerves are almost not stretched, and the intercostal muscles are not cut. Postoperative pain is significantly reduced compared to conventional thoracotomy. Furthermore, the integrity of the thorax is well preserved, and expectoration and deep breathing functions are almost unaffected. Early ambulation is achieved, significantly reducing the placement time of chest tubes and hospitalization duration. The incidence of postoperative complications such as atelectasis, pneumonia, and pleural effusion has also been significantly reduced.

After reviewing Mr. Liu's medical records, Professor Zhang Minghui made the following analysis and judgment:
1. The patient has early-stage lung cancer and has undergone surgical treatment.  

2. Although the patient has early-stage lung cancer, which is prone to pleural metastasis due to its close proximity to the lung membrane, they still fear postoperative recurrence. Postoperative chemotherapy for early-stage lung cancer does not meet the indications and can be harmful to the body.

3. NKT cell therapy utilizes powerful immune cells to eliminate tumor cells that may remain in the body, with essentially no side effects, providing a new option for preventing recurrence in patients who have undergone surgery for early-stage lung cancer.

In December 2020, Mr. Liu began NKT cell immunotherapy and completed five courses of treatment by May 2023. During these years of treatment, multiple follow-up examinations have shown no clear signs of tumor recurrence, and his overall condition remains stable.

 

Image Aspects

   
 


 

Tumor markers

Month  
 

Tumor marker: CEA. From November 4, 2021, to May 11, 2023, the reexamination results were slightly higher than normal, fluctuating between 5.42 and 8.27. Pay attention to future reexaminations.

The levels of cytokeratin 19 fragment, CA125, CA199, NSE, and SCC were within the normal range on September 2020 and December 23, 2021, and no further reexaminations were conducted thereafter.


 

 Conclusion and Comments

Mr. Liu reported that his physical condition had improved to some extent, and he felt more energetic than before. His quality of life score was 73.5 (previously 72).
Mr. Liu's lung cancer was detected and treated early, and he completed NKT cell therapy after surgery. Over the past two years, his overall condition has remained stable after multiple follow-ups, achieving the expected results.
A follow-up study was conducted on 112 patients with early-stage lung cancer who underwent Video-Assisted Thoracoscopic Surgery (VATS) lobectomy and lymph node dissection from 2016 to 2021. Among them, there were 72 males and 40 females. Lobectomy was performed on 106 patients, and double-lobectomy on 6 patients. The average operation time was 150.7±18 minutes. The follow-up results indicated that VATS is an effective and safe method for the surgical treatment of early-stage lung cancer. VATS lobectomy has fewer complications and a shorter hospital stay, and its five-year survival rate is consistent with that of thoracotomy.
Mr. Liu's lung cancer was at an early postoperative stage, but it still cannot be taken lightly. After completing surgery, combined NKT cell therapy can achieve long-term stability.
Popular science knowledge is provided for reference only. For individual patients, clinical treatment should prevail.   

Reference:< H427>

【1】D.K. Que, T. Nguyen,PP01.80 Long term Results of VATS Lobectomy for Early staged Non Small Cell Lung Cancer,Journal of Thoracic Oncology,Volume 18, Issue 3, Supplement.

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