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Vol.62 No.2 contents | Japanese/English |
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- Case Report -
A Case of a Long-term Survivor with EGFR Mutation-positive Non-small-cell Lung Cancer After Valve Replacement Under Extracorporeal Circulation and Aggressive Treatments Against Other Cardiovascular Complications During EGFR-tyrosine Kinase Inhibitor Treatment
Takamoto Saijo1, Akihiko Tanaka1, Yasutaka Yokoyama2,3, Takashi Uchiyama4, Atsushi Amano3, Norihiko Ikeda51Department of Internal Medicine, 2Department of Cardiovascular Surgery, Toda Central General Hospital, Japan, 3Department of Cardiovascular Surgery, Juntendo University Hospital, Japan, 4Department of Cardiology, Toda Central General Hospital, Japan, 5Department of Thoracic Surgery, Tokyo Medical University Hospital, Japan
Background. Owing to advances in chemotherapy, long-term survivors have been reported even in cases of advanced non-small-cell lung cancer (NSCLC). Because EGFR mutation-positive NSCLC responds well to EGFR-tyrosine kinase inhibitors (TKIs), active treatments including invasive surgery can be considered despite medical complications. To our knowledge, we experienced the world's first case of a long-term survivor of advanced NSCLC treated by valve replacement during EGFR-TKI treatment. Case. In a 76-year-old male (heavy smoker) with EGFR mutation-positive NSCLC, cTxN0M1a (stage IVA), aortic valvular replacement under extracorporeal circulation was performed for aortic stenosis at 38 months after the initiation of effective treatment with an EGFR-TKI for lung cancer. In addition, aggressive treatments for cardiovascular complications, such as PCI (percutaneous coronary intervention) for triple-vessel coronary artery disease and bypass surgery for common femoral artery aneurysm, were also performed during EGFR-TKI treatment, resulting in a long-term survival of 70 months in total. Conclusion. A long-term survival can be achieved even in cases of advanced NSCLC with serious medical complications by performing appropriate multidisciplinary treatments, including invasive surgery, when primary lung cancer is controlled medically. It should be stressed that a capable medical team contributes to better medical care in regional core hospitals.
key words: EGFR mutation-positive NSCLC, EGFR-TKI, Cardiovascular complications, Extracorporeal circulation, Valve replacement
Received: June 1, 2021
Accepted: November 4, 2021
JJLC 62 (2): 90-96, 2022
