Rationale: The optimal therapeutic regimen for chemotherapy-refractory and node-positive small-cell lung cancer (SCLC) is criticizable for the lack of evidence.
Patient concerns: A patient with locally advanced SCLC was insensitive to the first-line chemotherapy of etoposide, irinotecan, and cisplatin.
Diagnoses: The patient was diagnosed as SCLC with mediastinal lymph node metastasis by pathological staining.
Interventions: Salvage pneumonectomy and systematic lymph node dissection combined with oral apatinib and mediastinal radiotherapy were performed for him.
Outcomes: The patient survived for more than 2 years without recurrence after the operation and adjuvant therapy.
Lessons: For patients with chemotherapy-resistant but resectable SCLC, a timely resection combined with postoperative radiotherapy and apatinib might be effective.
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