ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Satoh, Y.
Right arrow Articles by Nakagawa, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Satoh, Y.
Right arrow Articles by Nakagawa, K.
Related Collections
Right arrow Lung - cancer
Right arrowRelated Article

Ann Thorac Surg 2007;83:197-202
© 2007 The Society of Thoracic Surgeons

Original Articles: General Thoracic

Recurrence Patterns in Patients With Early Stage Non-Small Cell Lung Cancers Undergoing Positive Pleural Lavage Cytology

Yukitoshi Satoh, MD, PhDa,b,c,*, Rira Hoshi, CTb, Yuichi Ishikawa, MD, PhDc, Takeshi Horai, MD, PhDb, Sakae Okumura, MDa, Ken Nakagawa, MDa

a Department of Thoracic Surgical Oncology, Cancer Institute Hospital, the Japanese Foundation for Cancer Research, Tokyo, Japan
b Department of Cytology, Cancer Institute Hospital, the Japanese Foundation for Cancer Research, Tokyo, Japan
c Department of Pathology, Cancer Institute, the Japanese Foundation for Cancer Research, Tokyo, Japan

Accepted for publication August 14, 2006.

* Address correspondence to Dr Satoh, Department of Thoracic Surgical Oncology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo 135-8550, Japan (Email: ysatoh{at}jfcr.or.jp).

BACKGROUND: 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).

METHODS: 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.

RESULTS: 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 (p < 0.002), 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.

CONCLUSIONS: 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.


Related Article

Invited commentary
Eric Lim
Ann. Thorac. Surg. 2007 83: 202-203. [Extract] [Full Text] [PDF]





HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2007 by The Society of Thoracic Surgeons.