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PostPosted: Sat Aug 26, 2017 9:18 pm 
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Joined: Wed Jun 14, 2017 4:03 pm
Posts: 220


Dear Dr West,
I am a cardiologist in Cyprus and my 63 year old father was diagnosed with BAC ( using tru-cut biopsy) mucinous type, a month ago. He was found to have an apical left lower lobe tumor of about 4 cm diameter in a CT scan.
After staging, the PET-CT revealed an SUVmax=2,4 of the tumor, a hilar enlargement (SUVmax=2,61) and a small paratracheal (4R) lymph node of 1 cm diameter in short axis with SUVmax=1,7.
He will be operated next week and the plan is:
if the mesothoracoscopy is negative for that small parathracheal (4R) lymph node after pathological confirmation, the surgeon will proceed to a left lower lobectomy.
The question is: what if the 4R lymph node is positive? Then it is N3. What we should do? The surgeon says that he should have the lobectomy. The oncologist is more conservative and he says that he should have down staging and then re-evaluation. But the oncologist says that there is a sub-population which there is a benefit after resection of the tumor if there is a low grade N3 disease.
I would be graceful if you could give me your opinion!

Thank You!!!

References
not allowed class="postlink" href="http://cancergrace.org/lung/topic/bronchioalveolar-cell-carcinoma/">http://cancergrace.org/lung/topic/bronc ... carcinoma/


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