Annals of Surgical Oncology, Vol 4, Issue 5 409-415, Copyright © 1997 by Society of Surgical Oncology

ARTICLES

Pleural lavage cytology immediately after thoracotomy and before closure of the thoracic cavity for lung cancer without pleural effusion and dissemination: clinicopathologic and prognostic analysis

M. Higashiyama, O. Doi, K. Kodama, H. Yokouchi, R. Tateishi, T. Horai, J. Ashimura, S. Nagumo and Y. Naruse
Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.

BACKGROUND: The significance of intraoperative pleural lavage cytology (PLC) in lung cancer patients without malignant effusion remains undetermined in terms of staging, prognosis, and local management. METHODS: PLC was performed both after thoractomy and before closure of the thoracic cavity in 325 patients with lung cancer without malignant pleurisy. RESULTS: According to the PLC results (positive [+] or negative [-] after thoracotomy/before closure), the patients were classified as follows: group A (-/-), 262 patients; group B (+/-), 19; group C (-/+), 22; and group D (+/+), 22. In comparison with group A, group C showed more advanced stage with aggressive nodal involvement, and group D showed more advanced lung cancer related to pleural and nodal involvement, whereas group B showed characteristics similar to those of group A. The rate of pleural recurrence in group D was the highest (26%). In particular, pleural recurrence was seen in the patients with a relatively large number of adenocarcinoma cells in PLC after thoractomy. The patients in groups C and D, especially those with adenocarcinoma, showed poorer prognosis, but in a multivariate analysis, PLC status was not an independent prognostic factor. CONCLUSIONS: PLC status after thoractomy provides useful information in the detection of high-risk subgroup for pleural recurrence. Although PLC status is closely associated with survival, its prognostic value is not independent.

This article has been cited by other articles:

				Y. Satoh, R. Hoshi, Y. Ishikawa, T. Horai, S. Okumura, and K. Nakagawa Recurrence Patterns in Patients With Early Stage Non-Small Cell Lung Cancers Undergoing Positive Pleural Lavage Cytology Ann. Thorac. Surg., January 1, 2007; 83(1): 197 - 202. [Abstract] [Full Text] [PDF]

				T. Nakagawa, N. Okumura, Y. Kokado, K. Miyoshi, T. Matsuoka, and K. Kameyama Clinical Relevance of Intraoperative Pleural Lavage Cytology in Non-Small Cell Lung Cancer Ann. Thorac. Surg., January 1, 2007; 83(1): 204 - 208. [Abstract] [Full Text] [PDF]

				G. Vicidomini, M. Santini, A. Fiorello, V. Parascandolo, B. Calabro, and V. Pastore Intraoperative Pleural Lavage: Is It a Valid Prognostic Factor in Lung Cancer? Ann. Thorac. Surg., January 1, 2005; 79(1): 254 - 257. [Abstract] [Full Text] [PDF]

				M. Higashiyama, K. Kodama, K. Takami, N. Higaki, T. Nakayama, and H. Yokouchi Malignant status at surgical margin of limited-resected non-small cell lung cancer: a crucial finding for predicting local relapse: Reply to the Editor J. Thorac. Cardiovasc. Surg., August 1, 2003; 126(2): 611 - 611. [Full Text] [PDF]

				M. Higashiyama, K. Kodama, K. Takami, N. Higaki, T. Nakayama, and H. Yokouchi Intraoperative lavage cytologic analysis of surgical margins in patients undergoing limited surgery for lung cancer J. Thorac. Cardiovasc. Surg., January 1, 2003; 125(1): 101 - 107. [Abstract] [Full Text] [PDF]

				X. Jiao and M. J. Krasna Clinical significance of micrometastasis in lung and esophageal cancer: a new paradigm in thoracic oncology Ann. Thorac. Surg., July 1, 2002; 74(1): 278 - 284. [Abstract] [Full Text] [PDF]

				M. Higashiyama, K. Kodama, K. Takami, N. Higaki, H. Yokouchi, T. Nakayama, K. Murata, M. Kameyama, J.-i. Ashimura, Y. Naruse, et al. Intraoperative Lavage Cytologic Analysis of Surgical Margins as a Predictor of Local Recurrence in Pulmonary Metastasectomy Arch Surg, April 1, 2002; 137(4): 469 - 474. [Abstract] [Full Text] [PDF]

				N. Sawabata, A. Matsumura, A. Motohiro, Y. Osaka, K. Gennga, S. Fukai, and T. Mori Malignant minor pleural effusion detected on thoracotomy for patients with non-small cell lung cancer: is tumor resection beneficial for prognosis? Ann. Thorac. Surg., February 1, 2002; 73(2): 412 - 415. [Abstract] [Full Text] [PDF]

				M. Higashiyama, K. Kodama, H. Yokouchi, K. Takami, T. Nakayama, and T. Horai A novel test of the surgical margin in patients with lung cancer undergoing limited surgery: Lavage cytologic technique J. Thorac. Cardiovasc. Surg., August 1, 2000; 120(2): 412 - 413. [Full Text] [PDF]

				X. Jiao, M. Zhang, Z. Wen, and M. J. Krasna Pleural lavage cytology in esophageal cancer without pleural effusions: clinicopathologic analysis Eur. J. Cardiothorac. Surg., May 1, 2000; 17(5): 575 - 579. [Abstract] [Full Text] [PDF]

				C. M. Dresler, C. Fratelli, and J. Babb Prognostic value of positive pleural lavage in patients with lung cancer resection Ann. Thorac. Surg., May 1, 1999; 67(5): 1435 - 1439. [Abstract] [Full Text] [PDF]