Tumor cells in intraoperative pleural lavage. An indicator for the poor prognosis of bronchogenic carcinoma

Buhr, J; Berghäuser, K. H.; Morr, H; Dobroschke, J; Ebner, H

doi:10.1002/1097-0142(19900415)65:8<1801::aid-cncr2820650822>3.0.co;2-9

Cited by 54 publications

(20 citation statements)

References 9 publications

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“…After independent review, 24 publications dealing with prognostic value of PLC in patients with lung cancer were considered to be eligible for inclusion in the analysis . Of these publications, one was excluded because it did not allow the calculation of HR [26], four were excluded because no survival data in negative PLC group were available [6,[27][28][29], three were excluded because the same authors published several reports on the same patients, and only the best-quality study was considered [30][31][32], three were excluded because they did not provide sufficient data to perform a quantitative aggregation [5,33,34]. Subsequently, 15 articles [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] were available for analysis of the PLC prognostic significance; the clinical characteristics of these studies, along with ELCWP scores, are outlined in Table 1, and the ELCWP scores in detail are shown in Appendix Table 1 (provided in supplemental material on the Web).…”

Section: Resultsmentioning

confidence: 99%

Prognostic significance of pleural lavage cytology in patients with lung cancer: A meta-analysis

Shi

Liang

et al. 2008

Lung Cancer

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Section: Resultsmentioning

confidence: 99%

Prognostic significance of pleural lavage cytology in patients with lung cancer: A meta-analysis

Shi

Liang

et al. 2008

Lung Cancer

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“…So, pleural lavage performed before lung resection can be used to identify whether tumor cells spread in pleural cavity. Buhr et al argued that significant correlation was found between positive pleural lavage cytology before resection and pleural invasion [20]. Nagawara et al also had similar findings and argued that in cases with positive cytology there is an increase of risk of pleural invasion and recurrence [21].…”

Section: Discussionmentioning

confidence: 92%

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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“…Three recent studies have examined the predictive value of preresectional pleural lavage in patients without an effusion. In 1990, Buhr and associates [3] studied 59 patients undergoing curative resection for primary lung cancer. They identified a 45.7% positivity: 39.5% in stage I, 50% in stage II, and 71.4% in stage III.…”

Section: Discussionmentioning

confidence: 99%

Pleural Lavage: A Novel Diagnostic Approach For Diagnosing Exudative Pleural Effusion

Mohamed

Mobasher

Yousef

et al. 2000

Lung

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Patients with pleural effusions frequently present a diagnostic and therapeutic challenge. The diagnosis is based on the interpretation of the results of thoracentesis or pleural biopsy. When a malignant tumor metastasizes to the pleura, tumor cells can be seeded over the mesothelial surface or in the subserous layer. In the former situation, tumor cells are abundant in pleural fluid, but in the latter, few malignant cells are exfoliated into the pleural cavity, and microscopic deposits may not be visualized at thoracoscopy. Pleural lavage cytologic study at the time of thoracoscopy has not been studied. The purpose of this study was to assess the value of thoracoscopic pleural lavage as an adjuvant in the diagnostic workup of patients with exudative pleural effusions. Fifty patients with exudative pleural effusions were investigated by pleural fluid cytologic findings, Abram's pleural biopsy, thoracoscopy, and pleural lavage cytologic findings. After aspiration of all pleural fluid, 300 mL saline was instilled into the pleural cavity and then recovered for cytologic analysis. The final diagnoses were 32 malignant (64%), 15 tuberculous (30%), and 3 idiopathic (6%) effusions. In the malignant group, thoracoscopic biopsy had the highest yield (94%) followed by lavage cytologic analysis (84%), fluid cytologic analysis (62%), and biopsy with Abram's needle (50%). The sensitivity of combined thoracoscopy and lavage cytologic analysis was 96%. In the patients with tuberculous pleuritis, the yield from the pathologic examination of the biopsy specimen was 93% with thoracoscopy and 60% with the Abrams needle. The diagnostic yield with cytologic analysis on pleural lavage fluid is significantly higher than that on pleural fluid. This is probably because the cells in the lavage fluid are fresher and better preserved than those in the regular pleural fluid, which may have undergone degenerative changes, yielding false-negative results. Pleural lavage cytologic analysis should be performed in patients with suspected malignant pleural effusion who are subjected to diagnostic thoracoscopy, because it may provide additional information to thoracoscopic biopsy.

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Tumor cells in intraoperative pleural lavage. An indicator for the poor prognosis of bronchogenic carcinoma

Cited by 54 publications

References 9 publications

Prognostic significance of pleural lavage cytology in patients with lung cancer: A meta-analysis

Prognostic significance of pleural lavage cytology in patients with lung cancer: A meta-analysis

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

Pleural Lavage: A Novel Diagnostic Approach For Diagnosing Exudative Pleural Effusion

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