Recurrence Patterns in Patients With Early Stage Non-Small Cell Lung Cancers Undergoing Positive Pleural Lavage Cytology
| Autor: | Takeshi Horai, Ken Nakagawa, Yukitoshi Satoh, Yuichi Ishikawa, Sakae Okumura, Rira Hoshi |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Adolescent Pleural effusion Gastroenterology Carcinoma Non-Small-Cell Lung Internal medicine Adjuvant therapy Carcinoma Humans Medicine Prospective Studies Radical surgery Stage (cooking) Therapeutic Irrigation Survival rate Aged Neoplasm Staging Aged 80 and over Lung business.industry Respiratory disease Middle Aged Prognosis medicine.disease respiratory tract diseases Surgery Survival Rate medicine.anatomical_structure Pleura Female Neoplasm Recurrence Local Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 83:197-202 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2006.08.025 |
| Popis: | Cytologic approaches such as pleural lavage cytology (PLC) are considered as possible aids to assessing prognosis of lung cancers. However, there is some controversy whether radical surgery is warranted based on the positive PLC findings with stage I non-small cell lung cancers (NSCLCs).From January 1991 to December 2002, PLC was performed before any manipulation or resection of the lung for 853 consecutive patients who had no macroscopic pleural effusion, dissemination, or diffuse adhesions and who subsequently underwent curative resection for NSCLCs. Results of PLC with reference to clinicopathologic characteristics, adjuvant therapy, 5-year survival, and recurrence patterns were analyzed.PLC findings were positive in 41 patients (4.8%), rates being most frequent with adenosquamous carcinomas and adenocarcinomas. In the positive group, distant metastases (72%) and pleural recurrence (25%) (p = 0.0011) were often observed, and the survival rate was significantly poorer (p0.002), even for patients with stage I disease (p = 0.009). As adjuvant therapies in the positive group after resection, 6 patients received hypotonic cisplatin and 15 received a distilled water infusion into the pleural space. Although only 2 patients had pleural recurrence, these therapies did not improve long-term outcome.PLC is a distinct prognostic factor for early stage lung carcinomas. Thus, we suggest that cytologic examination of PLC should be routine, even for patients with stage I NSCLCs before beginning lung resection. Moreover, curative resection, followed by adjuvant systemic therapy, could be necessary for improvement of outcome. |
| Databáze: | OpenAIRE |
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