Pleural Lavage Cytology Immediately After Thoracotomy in Patients With Completely Resected Non–Small Cell Lung Cancer

Hanagiri, Takeshi; Takenaka, Masaru; Oka, Soich; Baba, Tetsuro; Shigematsu, Yoshiki; Nagata, Yoshika; Shimokawa, Hidehiko; Yasuda, Manabu; Uramoto, Hidetaka; Takenoyama, Mitsuhiro; Yasumoto, Kosei

doi:10.9738/1395.1

Cited by 8 publications

(6 citation statements)

References 21 publications

(23 reference statements)

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“…Positive pre-resection PLC proved to be a strong independent adverse prognostic factor, positive post-resection PLC was also a strong predictor for a poor prognosis. Although 7.3% of lung cancer patients had a positive finding of PLC in our study, the presence of malignant cells in the pleural cavity without apparent pleural effusion indicates the aggressive biologic behavior of the tumor, including cell exfoliation, migration, and extravasation [ 60 ]. Therefore, we suggest that a cytological examination of PLC should be performed routinely in patients with lung cancer resection, whether before or after curative resection.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Pleural Lavage Cytology in Patients with Lung Cancer Resection: An Updated Meta-Analysis

Wang

Ling

et al. 2016

PLoS ONE

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ObjectivePleural lavage cytology (PLC) is considered as a possible tool for assessing prognosis of lung cancer patients. We aimed to comprehensively review the prognosis value of PLC in patients undergoing surgical resection.MethodsWe searched 4 electronic databases for relevant studies comparing positive PLC and negative PLC. The primary outcomes included survival rate and recurrence rate at maximum follow-up.ResultsThe meta-analysis included 28 studies, with a total of 20,714 patients. For the overall survival rate of all stages, the results demonstrated that positive pre-resection, post-resection and pooled PLC were associated with unfavorable survival: hazard ratio (HR) 2.89 (95% confidence interval [CI] 2.48–3.37), 2.70 (1.90–3.83), and 2.89 (2.52–3.31), respectively. For the stage I survival rate, the combined results also suggested that positive pre-resection, post-resection and pooled PLC were associated with unfavorable survival: HR 3.29 (95% CI 2.55–4.25), 4.85 (2.31–10.20), and 3.16 (2.53–3.94), respectively. Furthermore, a meta-analysis of 14 studies included 14,279 patients showed that positive pre-resection, post-resection and pooled PLC were associated with an increased risk of overall recurrence: risk ratio (RR) 2.45 (95% CI 1.91–3.15), 2.37 (1.11–5.09), and 2.37 (95% CI 2.00–2.80), respectively. Positive PLC was also associated with a high pleural recurrence (RR 4.77; 95% CI 3.13–7.26) or distant recurrence (RR 2.33; 95% CI 1.65–3.29).ConclusionsBoth positive pre- resection and post-resection PLC are associated with not only higher tumor recurrence but also unfavorable survival outcomes in patients with lung cancer resection. This technique can therefore act as a strong prognostic factor for tumor recurrence and adverse survival rates.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Pleural Lavage Cytology in Patients with Lung Cancer Resection: An Updated Meta-Analysis

Wang

Ling

et al. 2016

PLoS ONE

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“…And it could affect prognosis and prolong hospitalization [12]. Furthermore, the residual tumor cells may increase the risk of recurrence [13] and metastasis [14][15][16]. And if the volume of pleural lavage is excessive, it will cause waste of resources and prolongation of operation time.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the clinical benefits for non-small cell lung cancer patients between different volume of pleural lavage fluid following video-assisted thoracoscopic lobectomy and systematic mediastinal lymph node dissection: study protocol for a randomized controlled trial

Zhou

Liu

Man³

et al. 2020

Preprint

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Background: Pleural lavage is regularly performed before closing chest wall in pulmonary surgeries to prevent pleural implantation of tumor cells and postoperative infection. However, scant data could be found in the literature regarding the optimal regimen for performing pleural lavage.To establish a propervolume of pleural lavage, we herein designed this randomized controlled trial. Methods: A total of 400 participants with non-small cell lung cancer (NSCLC) undergoing video-assisted thoracoscopic surgery (VATS) lobectomy and systematic mediastinal lymph node dissection (MLND) will be randomly assigned into 2 groups: Group A (500ml pleural lavage fluid) and Group B (3000ml pleural lavage fluid). The primary outcomes include the levels of leukocytes, neutrophils, inflammatory factors on the first postoperative day. The secondary outcomes include: (i) the levels of leukocytes, neutrophils, inflammatory factors on the second and third postoperative day; (ii) the incidence of postoperative fever on the first, second and third postoperative day; (iii) the volumes of chest drainage within the first 3 operative days, the duration of drainage, and postoperative hospitalization; (iv) the incidence of postoperative complications (incision infection, pain, atelectasis, hemorrhage, etc.),and the incidence of pleural effusion requiring thoracic puncture or drainage within 30 days after surgery.The main content of the analysis includes effectiveness and safety analysis. We will perform subgroup analyses to identify potential influence factors. Discussion: This first randomized controlled trial is expected to compare the clinical outcomes between different volumes of pleural lavage fluid following VATS and MLND, and provide us evidence to develop a standardized procedure of pleural lavage before closing chest wall in lung cancer operation. Trial registration number: This study has been registered with the Chinese Clinical Trial Registry (ChiCTR1900021950) on 17 March 2019. The URL of the trial registry record is http://www.chictr.org.cn/listbycreater.aspx.

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“…Furthermore, the residual tumor cells may increase the risk of recurrence [13] and metastasis [14][15][16]. And if the volume of pleural lavage is excessive, it will cause waste of resources and prolongation of operation time.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the clinical benefits for non-small cell lung cancer patients between different volume of pleural lavage fluid following video-assisted thoracoscopic lobectomy and systematic mediastinal lymph node dissection: study protocol for a randomized controlled trial

Zhou

Liu

Man³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Pleural lavage is regularly performed before closing chest wall in pulmonary surgeries to prevent pleural implantation of tumor cells and postoperative infection. However, scant data could be found in the literature regarding the optimal regimen for performing pleural lavage. To establish a proper volume of pleural lavage, we herein designeda protocol for arandomized controlled trial. Methods: A total of 400 participants with non-small cell lung cancer (NSCLC) undergoing video-assisted thoracoscopic surgery (VATS) lobectomy and systematic mediastinallymph node dissection (MLND) will be randomly assigned into 2 groups: Group A (500ml pleural lavage fluid) and Group B (3000ml pleural lavage fluid). The primary outcomes include the levels of leukocytes, neutrophils, inflammatory factors on the first postoperative day. The secondary outcomes include: (i) the levels of leukocytes, neutrophils, inflammatory factors on the second and third postoperative day; (ii) the incidence of postoperative fever on the first, second and third postoperative day; (iii) the volumes of chest drainage within the first 3 operative days, the duration of drainage, and postoperative hospitalization; (iv) the incidence of postoperative complications (incision infection, pain, atelectasis, hemorrhage, etc.), and the incidence of pleural effusion requiring thoracic puncture or drainage within 30 days after surgery.The main content of the analysis includes effectiveness and safety analysis. We will perform subgroup analyses to identify potential influence factors. Discussion: As far as we know, this will bethe first randomized controlled trial is expected to compare the clinical outcomes between different volumes of pleural lavage fluid following VATS and MLND. Findings from this trial will determine the appropriate amount of pleural lavage before chest wall closure. Trial registration number: This study has been registered with the Chinese Clinical Trial Registry (ChiCTR1900021950) on 17 March 2019. The URL of the trial registry record is http://www.chictr.org.cn/showprojen.aspx?proj=37003.

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Pleural Lavage Cytology Immediately After Thoracotomy in Patients With Completely Resected Non–Small Cell Lung Cancer

Cited by 8 publications

References 21 publications

Prognostic Value of Pleural Lavage Cytology in Patients with Lung Cancer Resection: An Updated Meta-Analysis

Prognostic Value of Pleural Lavage Cytology in Patients with Lung Cancer Resection: An Updated Meta-Analysis

Comparison of the clinical benefits for non-small cell lung cancer patients between different volume of pleural lavage fluid following video-assisted thoracoscopic lobectomy and systematic mediastinal lymph node dissection: study protocol for a randomized controlled trial

Comparison of the clinical benefits for non-small cell lung cancer patients between different volume of pleural lavage fluid following video-assisted thoracoscopic lobectomy and systematic mediastinal lymph node dissection: study protocol for a randomized controlled trial

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