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Ann Thorac Surg 1999;67:1435-1439
© 1999 The Society of Thoracic Surgeons

Original Articles

Prognostic value of positive pleural lavage in patients with lung cancer resection

Carolyn M. Dresler, MDa, Cori Fratellia, James Babb, PhDa

a Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA

Accepted for publication October 26, 1998.

Address reprint requests to Dr Dresler, Medical Affairs for Smoking Control, SmithKline Beecham Consumer Healthcare, 1500 Littleton Rd, Parsippany, NJ 07054

Background. Despite an early stage, lung cancer patients often have a poor survival, suggesting inaccurate staging. A pleural lavage demonstrating malignant cells at the time of operation may predict a poorer survival, particularly in patients with otherwise early disease.

Methods. Patients, with no preoperative evidence of pleural effusions and undergoing a surgical resection with curative intent, had a preresectional and postresectional lavage to be evaluated by cytology.

Results. Fourteen percent of patients with stage I disease had malignant cells in their preresectional lavage and had a significantly shorter survival than stage I patients with a negative lavage. Positivity of preresectional lavage was not correlated with nodal status, pleural or lymphatic involvement, or histologic findings.

Conclusions. Preoperative pleural lavage should become a standard technique intraoperatively to better characterize and stage patients undergoing lung cancer resections. Patients with malignant cells in their preoperative lavage should be upstaged.




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