. Step 40 of 40
Clinical Stem 2
A patient with pulmonary nodules 1 year after curative intent resection of primary lung adenocarcinoma

Case Conclusion
The patient did not want to be hospitalized. She requested further systemic therapy if symptoms improved, or home hospice if they did not. A tunneled pleural catheter was therefore inserted. The procedure was performed and the patient was discharged home the same day. Dyspnea resolved and spontaneous pleurodesis was noted six weeks later. The indwelling catheter was removed during an outpatient follow-up visit. The patient's ECOG score had improved from 4 to 2. She preferred to travel and spend time with her family rather than be enrolled in a clinical trial.


References:
  1. Olaussen et al. DNA Repair by ERCC1 in Non?Small-Cell Lung Cancer and Cisplatin-Based Adjuvant Chemotherapy. N Engl J Med. 2006;355:983-991
  2. Rosell R et al: Ribonucleotide reductase mRNA expression and survival in gemcitabine/cisplatin-treated advanced non-small-cell lung cancer patients. Clin Cancer Res 10:1318-1325, 2004.
  3. Kawaguchi T, Takada M, Kubo A, et al. Performance status and smoking status are independent favorable prognostic factors for survival in non-small cell lung cancer: a comprehensive analysis of 26,957 patients with NSCLC. J Thorac Oncol 2010;5:620-630.
  4. Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733-742
Each fictitious clinical case scenario is based on a conglomerate of real patient data. Cases have been modified to avoid any possibility for patient identification and to help meet educational objectives. Any resemblance to real persons, living or deceased, is purely coincidental.

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