TY - JOUR
T1 - The impact on survival of positive intraoperative pleural lavage cytology in patients with non-small-cell lung cancer
AU - Aokage, Keiju
AU - Yoshida, Junji
AU - Ishii, Genichiro
AU - Enatsu, Sotarou
AU - Hishida, Tomoyuki
AU - Nishimura, Mitsuyo
AU - Nishiwaki, Yutaka
AU - Nagai, Kanji
N1 - Funding Information:
This study was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare , Japan.
PY - 2010/5
Y1 - 2010/5
N2 - Objective: The aim of this study was to analyze intraoperative pleural lavage cytology results in patients with non-small-cell lung cancer and quantify the impact on survival and recurrence. Methods: From August 1992 through November 2006, pleural lavage cytology results before and after lung resection were both available in 2178 patients with non-small-cell lung cancer. We assessed the pre-pleural lavage cytology impact on survival, comparing with 9 factors available before lung resection by multivariate analyses. We also compared the impact with that of pleural dissemination or malignant pleural effusion. For post-pleural lavage cytology, we analyzed its survival impact in relation with 15 clinicopathologic factors, including those available after resection, by multivariate analyses. Results: Pre-pleural lavage cytology proved to be a strong independent prognostic factor, but the 5-year survival rate was 37% in 65 patients without dissemination but with a positive pre-pleural lavage cytology, which was significantly higher than 12% in 86 patients with dissemination. When factors available after resection were combined, post-pleural lavage cytology showed a stronger survival impact than pre-pleural lavage cytology. Post-pleural lavage cytology was also a strong predictor of recurrence. The positive post-pleural lavage cytology group had a marginally, but not significantly, better survival compared with the malignant pleural effusion group. Almost all patients with positive post-pleural lavage cytology relapsed within 5 years. Conclusions: Pre-pleural lavage cytology is of less use in clinical practice. Post-pleural lavage cytology was a very strong independent prognostic factor, and almost all patients with positive post-pleural lavage cytology relapsed within 5 years. We propose that positive post-pleural lavage cytology disease should be classified to pathologic T4 and managed similarly to dissemination.
AB - Objective: The aim of this study was to analyze intraoperative pleural lavage cytology results in patients with non-small-cell lung cancer and quantify the impact on survival and recurrence. Methods: From August 1992 through November 2006, pleural lavage cytology results before and after lung resection were both available in 2178 patients with non-small-cell lung cancer. We assessed the pre-pleural lavage cytology impact on survival, comparing with 9 factors available before lung resection by multivariate analyses. We also compared the impact with that of pleural dissemination or malignant pleural effusion. For post-pleural lavage cytology, we analyzed its survival impact in relation with 15 clinicopathologic factors, including those available after resection, by multivariate analyses. Results: Pre-pleural lavage cytology proved to be a strong independent prognostic factor, but the 5-year survival rate was 37% in 65 patients without dissemination but with a positive pre-pleural lavage cytology, which was significantly higher than 12% in 86 patients with dissemination. When factors available after resection were combined, post-pleural lavage cytology showed a stronger survival impact than pre-pleural lavage cytology. Post-pleural lavage cytology was also a strong predictor of recurrence. The positive post-pleural lavage cytology group had a marginally, but not significantly, better survival compared with the malignant pleural effusion group. Almost all patients with positive post-pleural lavage cytology relapsed within 5 years. Conclusions: Pre-pleural lavage cytology is of less use in clinical practice. Post-pleural lavage cytology was a very strong independent prognostic factor, and almost all patients with positive post-pleural lavage cytology relapsed within 5 years. We propose that positive post-pleural lavage cytology disease should be classified to pathologic T4 and managed similarly to dissemination.
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U2 - 10.1016/j.jtcvs.2009.07.049
DO - 10.1016/j.jtcvs.2009.07.049
M3 - Article
C2 - 19765741
AN - SCOPUS:77950916991
SN - 0022-5223
VL - 139
SP - 1246-1252.e1
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 5
ER -
