The impact on survival of positive intraoperative pleural lavage cytology in patients with non–small-cell lung cancer Keiju Aokage, MD, Junji Yoshida,

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Presentation transcript:

The impact on survival of positive intraoperative pleural lavage cytology in patients with non–small-cell lung cancer Keiju Aokage, MD, Junji Yoshida, MD, Genichiro Ishii, MD, Sotarou Enatsu, MD, Tomoyuki Hishida, MD, Mitsuyo Nishimura, MD, Yutaka Nishiwaki, MD, Kanji Nagai, MD The Journal of Thoracic and Cardiovascular Surgery Volume 139, Issue 5, Pages 1246-1252.e1 (May 2010) DOI: 10.1016/j.jtcvs.2009.07.049 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Patients enrolled in the study. NSCLC, Non–small-cell lung cancer; PLC, pleural lavage cytology. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1246-1252.e1DOI: (10.1016/j.jtcvs.2009.07.049) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Survival curves of patients with dissemination and/or malignant effusion (D+) and patients with positive pre-PLC without dissemination/malignant effusion (D− and pre-PLC+). Survival was significantly better in D− and pre-PLC+ group (5-year survival rate: 37%) than in D+ group (11%; P = .002). B, Survival curves of patients with dissemination and/or malignant effusion (D+) and patients with positive post-PLC without dissemination and/or malignant effusion (D− and post-PLC+). Survival rates did not differ significantly between the 2 groups (P = .166). The fine vertical bars in each graph indicate the standard error for each data point. PLC, Pleural lavage cytology. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1246-1252.e1DOI: (10.1016/j.jtcvs.2009.07.049) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A, Overall survival curves of patients according to post-PLC results. The 22% 5-year survival rate for patients with positive post-PLC was significantly worse than 69% for patients with negative post-PLC (P < .001, log-rank test). B, Recurrence-free survival curves of patients according to post-PLC results. The 4% 5-year recurrence-free survival rate for patients with positive post-PLC was much worse than the 67% for patients with negative post-PLC (P < .001, log-rank test). The fine vertical bars in each graph indicate the standard error for each data point. PLC, Pleural lavage cytology. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1246-1252.e1DOI: (10.1016/j.jtcvs.2009.07.049) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 The Kaplan-Meier curves of 4 groups: pre-PLC−/post-PLC−, pre-PLC+/post-PLC−, pre-PLC−/post-PLC+, pre-PLC+/post-PLC+. The survivals were similarly poor for positive post-PLC groups regardless of pre-PLC results and were significantly worse than negative post-PLC groups. The fine vertical bars in each graph indicate the standard error for each data point. PLC, Pleural lavage cytology. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1246-1252.e1DOI: (10.1016/j.jtcvs.2009.07.049) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Mechanism of pleural dissemination. Macroscopic pleural dissemination is an indicator to discontinue resection, but it is not clear how to deal with patients with positive pre-PLC. PLC, Pleural lavage cytology. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1246-1252.e1DOI: (10.1016/j.jtcvs.2009.07.049) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions