Adjuvant therapy for well differentiated multi focal adenocarcinoma? - 1272800

graceuser
Posts:2

I got right upper lobectomy done recently and am trying to investigate if I need adjuvant chemo or not.

- 43 year old non smoker female
- Well differentiated Adenocarcinoma (60% acinar)
- Multi nodules in right upper lobe - largest nodule 3cm
- Remaining nodules range from .2-1.0 cm (on PET these smaller nodules had a max SUV of less than 2)
- Pleural elastic layer invasion - present
- No lymp nodes involved (12 nodes checked)
- No visceral pleural or No parietal pleural or No vascular involvement identified
- x-rays over a 5-6 month period showed no progression (slow growing)

We would really appreciate your thoughts.

Thanks!

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Reply # - January 31, 2016, 09:06 AM

JimC
Posts: 2753

Hi graceuser,

Welcome to GRACE. I'm sorry to hear of your diagnosis, but it is encouraging to see that it has been slow growing and that spread has been quite limited.

Normally with a tumor of 3 cm or less, surgery without chemotherapy is the standard of care, unless there are other factors. In your case, the factors which would influence the decision would be the presence of pleural elastic layer invasion and multiple nodules. For a young and presumably fit patient such as yourself, most oncologists would favor adjuvant chemotherapy in an effort to eradicate any remaining cancer cells which may be present, providing a small but possibly important increase in cure rate.

It may help to review Dr. Weiss' "Introduction to Lung Cancer".

JimC
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