Prognostic significance of pleural lavage cytology after resection for non-small cell lung cancer

Kotoulas, Christophoros; Lazopoulos, George; Karaiskos, Theodoros; Tomos, Pericles; Konstantinou, Marios; Papamichalis, George; Politi, Dimitra; Lioulias, Achilleas

doi:10.1016/s1010-7940(01)00718-7

Cited by 25 publications

(15 citation statements)

References 9 publications

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“…Positive cytology has been found to be more frequently associated with adenocarcinomas, N2 disease, stage III tumors, in tumors in which there is visceral pleural involvement, in the presence of lymphatic permeation, or vascular invasion. It has invariably been associated with increased recurrence and a worse prognosis [47][48][49][50][51][52]. It is unlikely that one can achieve complete resection in tumors in which pleural lavage cytology is positive.…”

Section: Pleural Lavage Cytologymentioning

confidence: 99%

Complete resection in lung cancer surgery: proposed definition

Wittekind²,

2005

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Section: Pleural Lavage Cytologymentioning

confidence: 99%

Complete resection in lung cancer surgery: proposed definition

Wittekind²,

2005

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“…It was found that 90% of the cases that underwent bilobectomy had tumors with irregular edge. Many scholars argue that exfoliation of tumor cells from metastatic lymph nodes into pleural cavity after surgical manipulations lead to positive cytology after lung resection [23,24]. Although the reason for positive cytology is not yet fully known, we do not think that this theory is completely valid.…”

Section: Discussionmentioning

confidence: 88%

The Impact of Pleural Lavage Cytology Before and After Resection on Prognosis

Özkan¹

2017

Ann Clin Anal Med

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ÖzetAmaç: Plevral sıvı sitolojisinde tümör hücresi saptanması malignite açısın-dan ileri evre ve kötü prognoz göstergesidir. Çalışmamızda plevral sıvısı olmayan operabl malignite olgularında peroperatif plevral lavaj ile saptanabilecek tümör pozitifliğinin kitle ve mediastinal lenf nodu özelliklerine göre analizi amaçlanmıştır. Gereç ve Yöntem: Küçük hücrteli dışı akciğer kanseri nedeni ile opere edilen 199 olguda, diseksiyon öncesi ve rezeksiyon sonrası yapılan plevral lavajın sitolojik değerlendirme sonuçları cinsiyet, lezyon şekil ve boyutu, toraks bilgisayarlı tomografi ve Pozitron emisyon tomografisi (PET BT) lenf nodu tutulumu, lezyonun SUVmax değeri, lokalizasyonu, patolojik N1 ve N2 metastazı, lokal invazyon, tümörün histopatolojisi gibi değişkenler ile istatistiksel olarak karşılaştırıldı. Bulgular: Çalışmaya dahil edilen olgular 4 yıl takip edildi. On (%5) olguda tümör nüksü, 12 (%6) olguda uzak organ metastazı saptandı. Çok değişkenli analizde ilk lavaj sitolojisi ile uzak organ metastazı arasında ve son lavaj sitolojisi ile tümör nüksü arasında anlamlı iliş-ki saptanmıştır. Postoperatif uzak organ metastazının lenf nodu metastazı ve ilk lavaj sitoloji pozitifliği ile, tümör nüksünün PET BT lenf nodu tutulumu, lenf nodu metastazı ve son plevral lavaj sitoloji pozitifliği ile anlamlı düzeyde iliş-kisi saptanmıştır. Tartışma: Günümüzde plevral lavaj analizi ile ilgili çalışma-larda artışlar söz konusu olup lavaj zamanlaması ve örnek alımı ile ilgili standardizasyona ihtiyaç mevcuttur. Daha geniş seriler içeren çok merkezli çalış-malar sonucunda pozitif lavaj sitolojisinin evrelendirmede tıpkı malign efüz-yon gibi prognostik faktör olarak kabul edileceğini umuyoruz. Anahtar KelimelerAkciğer Kanseri; Plevral Lavaj; Sitoloji; Prognoz Abstract Aim: Regardless of pleural effusion, presence of tumor in pleural cavity indicates presence of more aggressive tumor. In this study, we analysed positive tumor results in preoperative pleural lavage in operable malignant cases with no pleural fluid according to the mass and mediastinal lymph node characteristics. Material and Method: Pleural lavage before preoperative dissection and after resection was performed on 199 cases that underwent surgery for non small cell lung cancer (NSCLC). Findings of lavage were statistically evaluated based on gender, lesion shape and size, lymph node involvement in positron emission tomography-computed tomography (PET-CT), SUV-max value of lesion, localisation of the lesion, N1 and N2 metastases, local invasion findings, histopathological type of tumor and type of resection. Results: Cases included in this study were followed for four years. Ten of the cases (5%) had tumor recurrence and 12 of them (6%) had distant organ metastasis. In multivariable analysis, significant correlation was found between the first positive pleural lavage cytology and postoperative distant organ metastasis; the last pleural lavage cytology and tumor recurrence; postoperative distant organ metastasis and lymph node metastasis and the first positive lavage c...

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“…Although the prognosis of patients who have primary lung cancer with positive PLC is poor [1][2][3][4], there have been no new therapeutic methods to alleviate these patients' condition. Recently, Ichinose et al [8] reported a prematurely trial of intrapleural hypotonic cisplatin treatment for PLC positive patients.…”

Section: Discussionmentioning

confidence: 99%

“…The prognosis of patients who have primary lung cancer with positive pleural lavage cytology (PLC) is poor compared to that of other patients who have lung cancer in the same histological stage, but are PLC negative [1][2][3][4]. Some investigators have insisted that we should treat patients with positive PLC the same as patients with malignant pleural effusions that are pathologically categorized to stage IIIB [5,6].…”

Section: Introductionmentioning

confidence: 99%