A recurrence-free survivor with chemotherapy-refractory small cell lung cancer after pneumonectomy: A case report and review of the literature.

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.