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Intraoperative Pleural Lavage: Is It a Valid Prognostic Factor in Lung Cancer?
- Source :
- The Annals of Thoracic Surgery. 79:254-257
- Publication Year :
- 2005
- Publisher :
- Elsevier BV, 2005.
-
Abstract
- Background In patients undergoing lung resection for non-small cell lung cancer (NSCLC), the primary TNM (tumor–regional lymph node–distant metastasis) staging system is the best prognostic factor. However, it is necessary to investigate other factors that could more accurately predict a patient's prognosis. In this study we evaluated the significance of positive intraoperative pre-resectional lavage in patients with NSCLC. Methods We enrolled 84 patients (79 men, 5 women) aged between 36 and 81 years (mean age, 64.8 years) undergoing a major lung resection for NSCLC, with no preoperative evidence of pleural effusions. Intraoperatively, the patients were given a pre-resectional pleural lavage with physiologic saline solution. The fluid was aspirated and sent to cytology. Results Pre-resectional pleural lavage was positive in 19 patients (22.6%). The lavage was positive in 7.3% in patients with early stage I disease (3/41) and 37.2% in patients with stage II/III disease. In the group of 16 patients with chest wall neoplastic involvement (T3), 9 had a positive lavage (56.2%; p = 0.05). No significant correlation was found between positive lavage and nodal status, visceral pleural involvement, or histologic findings. Patients with malignant cells in the pre-resectional lavage had a significantly shorter survival than patients with a negative lavage ( p = 0.025). Conclusions A positive cytology finding of intraoperative pre-resectional pleural lavage could be an important prognostic factor in patients undergoing major lung resection for NSCLC. Patients with a positive lavage should be upstaged. However, larger series are needed to define accurately the role of this technique in early stage lung cancer.
- Subjects :
- Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Lung Neoplasms
Pleural effusion
medicine.medical_treatment
Therapeutic irrigation
Adenocarcinoma
Metastasis
Pneumonectomy
Predictive Value of Tests
Carcinoma, Non-Small-Cell Lung
medicine
Carcinoma
Humans
Life Tables
Neoplasm Invasiveness
Stage (cooking)
Therapeutic Irrigation
Lung cancer
Aged
Neoplasm Staging
Aged, 80 and over
NSCLC
Pleural Cavity
Intraoperative Care
business.industry
Respiratory disease
pleural lavage
Middle Aged
Prognosis
medicine.disease
Survival Analysis
Pleural Effusion, Malignant
respiratory tract diseases
lung cancer
Carcinoma, Squamous Cell
Female
Surgery
Radiology
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 79
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....0468b02847b51f62a5583c46ce121db1