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Pleural lavage cytology predicts recurrence and survival, even in early non-small cell lung cancer

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Abstract

Purpose

The TNM staging remains the best prognostic descriptor of lung cancer; however, new independent prognostic factors are needed, particularly for early stage disease.

Methods

An evaluation of the pleural lavage cytology (PLC) was performed in 436 consecutive NSCLC patients who underwent surgical resection; clinical, pathological and follow-up data were available for 414 patients.

Results

The PLC was positive in 15 patients (3.6 %). The overall five-year survival was 35.9 % in PLC-positive and 57.8 % in PLC-negative patients (p = 0.004). To compare groups with the same prognostic characteristics, the analysis was restricted to p-stage I patients, but the survival remained worse in the PLC-positive patients (42.9 vs 69.4 %; p = 0.001). Recurrence was also observed more frequently in PLC-positive cases: 69.2 vs 34.5 %, OR 4.28 (95 % CI 1.29–14.18; p = 0.01). Among the PLC-positive patients, no difference between the local (44.4 %) and distant (55.6 %) relapse patterns was found (p = 0.82). The multivariate analysis identified four independent prognostic factors: age (p < 0.001), disease stage (p < 0.001), gender (p = 0.025) and PLC status (p = 0.012).

Conclusions

PLC is an independent prognostic factor for NSCLC. PLC-positive NSCLC patients have a worse overall survival and a higher recurrence rate, even in stage I disease. PLC-positive patients should be considered a high risk category, who should potentially be eligible for adjuvant therapy regardless of their p-stage.

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Acknowledgments

Federico Mazza: surgery, study design, data collection, manuscript writing, final manuscript approval. Enrico Ferrari: data collection, manuscript revision, final manuscript approval. Paola Maineri: surgery, data collection, manuscript revision, final manuscript approval. Beatrice Dozin: statistical analysis, manuscript writing, final manuscript approval. Giovanni Battista Ratto: surgery, study coordinator, manuscript writing, final manuscript approval.

Conflict of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Thoracic Surgery Unit, Santa Corona Hospital, Via XXV Aprile 38, 17027, Pietra Ligure, SV, Italy

    Federico Mazza & Paola Maineri

  2. Thoracic Surgery Unit, National Cancer Institute, A.O.U San Martino-IST, Largo Benzi 10, 16132, Genoa, Italy

    Enrico Ferrari & Giovanni Battista Ratto

  3. Clinical Epidemiology Unit, IRCCS-A.O.U San Martino-ST, Genoa, Italy

    Beatrice Dozin

Authors
  1. Federico Mazza
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  2. Enrico Ferrari
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  4. Beatrice Dozin
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  5. Giovanni Battista Ratto
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Correspondence to Federico Mazza.

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Mazza, F., Ferrari, E., Maineri, P. et al. Pleural lavage cytology predicts recurrence and survival, even in early non-small cell lung cancer. Surg Today 45, 322–328 (2015). https://doi.org/10.1007/s00595-014-0915-3

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  • DOI: https://doi.org/10.1007/s00595-014-0915-3

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