Bridging the Gap: Transforming Knowledge into Action
July 8-12, 2006, Washington, DC, USA
Sunday, 9 July 2006 - 2:30 PM 19-4
Pleural Lavage Cytology before and after Lung Resection in Non-Small Cell Lung Cancer Patients: the Largest Cohort Ever Studied
Sotarou Enatsu, MD, General Thoracic Surgery, Fukuoka University School of Medicine and National Cancer Center Hospital East, 2-4-13, Katae, Jonan-ku, Fukuoka, Japan
Objective:The aim of this study was to analyze on a multivariate basis the prognostic significance of pre-resection and post-resection PLC in surgically resected primary NSCLC patients, in relation to pathologic TNM factors in a large cohort of almost 1,200 patients. Methods:From August 1992 through March 2001, PLC was performed in 1,214 NSCLC patients without pleural effusion or dissemination undergoing pulmonary resection. To investigate the impact on patient survival, PLC results were analyzed with conventional clinicopathologic factors. Results:Definitive pre-resection PLC result was obtained in 1,194 patients and 38 had a positive result. The 5-year survival rates were 27% if pre-resection PLC was positive and 71% if negative. Of 1,198 patients 54 had a positive post-resection PLC result. The 5-year survival rates were 10% if post-resection PLC was positive and 73% if negative. On multivariate analysis, post-resection PLC was an independent prognostic factor as significant as established clinicopathologic factors. Conclusions. Pre-resection and post-resection PLC should be recognized as an essential prognostic factor and should be performed in NSCLC patients without pleural effusion and dissemination. Post-PLC, compared with pre-PLC, had a greater and independent impact on survival and needs to be incorporated in the pathological staging of NSCLC in the future.