Stage III Lung Adenocarcinoma Treated With Complex Lung-Sparing Surgery and Adjuvant Therapy

What happened, in summary

A 37-year-old man with a heavy smoking history developed a persistent cough. Imaging found a central left lung mass involving major hilar structures, and biopsy confirmed lung adenocarcinoma with micropapillary features. PD-L1 expression was high, and the cancer was classified as Stage III.

To remove the cancer while preserving as much functioning lung as possible, he underwent a complex operation. The left lung was removed, the cancer-involved upper lobe was excised outside the body, and the healthy lower lobe was reimplanted by reconnecting its airway and blood vessels. Pathology confirmed Stage III disease with involved nearby lymph nodes and clear surgical margins.

After recovering from surgery, he received 4 cycles of pemetrexed and carboplatin chemotherapy along with a course of PD-L1-directed immunotherapy that continued for 16 cycles. He did not experience severe immune-related side effects.

Follow-up imaging at 2 and 3 years after surgery showed no recurrence or metastatic disease. His lung function remained stable, and he reported a high quality of life with unrestricted physical activity.