[Combined Resection of the Aorta under Cardiopulmonary Bypass for Locally Advanced Lung Cancer]

We present two cases with locally advanced lung cancer invading the descending aorta. Case 1 is a 67 years old male, who had been followed up for stroke. Enlargement of a mass lesion in the left lung was pointed out on further examination. Case 2 is a 64-year-old man, who was referred to our hospital because of cough and abnormal shadow on the chest X-ray and computed tomography (CT). We suspected that both tumors were lung carcinoma invading the descending aorta based on enhanced CT findings. In both cases, the clinical stage was cT4N0M0 stageⅢA. They underwent left pneumonectomy with combined en bloc tubular resection and reconstruction of the descending aorta via a posterolateral thoracotomy using cardiopulmonary bypass in the right lateral decubitus position. The histologic type of both tumors was squamous cell carcinoma. The pathological staging was pT4N0M0 in case 1, and pT4N2M0 in case 2. After surgery, the first patient received chemotherapy consisting of carboplatin and vinorelbine plus pembrolizumab. He survived 17 months until sudden death of unknown reason. The second did not receive adjuvant treatment because his postoperative performance status was slightly reduced. He died of local recurrence 6 months after the operation.