Long-term outcome of surgical resection for residual or regrown advanced non-small cell lung carcinomas following EGFR-TKI treatment: report of four cases

We report the long-term outcome of 4 patients who underwent pulmonary resection for residual or regrown primary lesion of non-small cell lung cancer (NSCLC) treated with a epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) gefitinib. Two patients underwent surgical resection for localized regrown primary lesion after gefitinib for stage IV disease. The remaining two patients underwent surgery for localized residual primary lesion that was downstaged to N0 after gefitinib for initially inoperable cN2 (stage IIIA) disease. Three patients developed recurrence with a median progression-free period of 1.2 years (0.2–2.2), but they survived more than 5 years postoperatively with good local control. One patient who initially had cN2 disease is alive without recurrence after 4 years with continued postoperative gefitinib. Although our series is small, the relatively favorable long-term survival indicates the need for further investigation of the role of surgery during molecular-targeted therapy for advanced NSCLC.