Clinical value of pleural lavage cytological positivity in lung cancer patients without intraoperative malignant pleuritis

Abstract

The semiquantitative evaluation of tumor cell clusters in pleural lavage cytology-positive patients provided useful information on postoperative recurrence. Since Type III patients are at high-risk for pleural recurrence, postoperative therapy targeting local control should be conducted in such patients.

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

“…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).…”

Prognostic value of intraoperative pleural lavage cytology for lung cancer without carcinomatous pleuritis: importance in patients with early stage disease during long-term follow-up☆

“…Patients in whom pleural dissemination or malignant effusion was intraoperatively found were excluded from the present analysis. Some of the present tested patients were included in the previously reported studies [9,10].…”

“…The method of PLC immediately after thoracotomy was previously described [9,10]. Briefly, the pleural cavity was washed with about 200 ml of physiological saline solution, most of which was then collected into a glass bottle with a mixture of heparin.…”

“…Considering the clinical findings of the PLC status in relation to tumor progression and poor prognosis, distant metastases were easily regarded as the major pattern of tumor recurrence among PLC-positive patients [2], in particular those with advanced stage disease. On the other hand, positive PLC findings in patients have been described as reliable information for potential carcinomatous pleuritis by many investigators [2,6,9,10]. The rate of pleural recurrence among such PLC-positive patients was considered to be 15-35%.…”

“…Next, we analyzed the postoperative recurrence pattern of PLC-positive patients but in these studies the follow-up periods after operation, as well as the number of patients tested, were insufficient to reach conclusions about the PLC significance [10]. Therefore, we reviewed the surgical results of lung cancer patients without carcinomatous pleuritis followed up for a long period, and re-analyzed the PLC implications, especially for prognosis and recurrence patterns.…”