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☆

Higashiyama, Masahiko; Oda, Kazuyuki; Okami, Jiro; Maeda, Jun; Kodama, Ken; Takenaka, Akemi; Nakayama, Tomio; Yoneda, Genichiro

doi:10.1016/j.ejcts.2008.10.013

Cited by 20 publications

(11 citation statements)

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“…In multivariate analyses, 18 studies [20], [31], [37], [39], [41], [42], [47], [49], [51], [53], [55], [57], [58], [61], [64]–[67] were significant compared with 13 studies [19], [21], [27], [29], [34], [40], [44], [46], [48], [54], [63], [68], [69] with non-significant results. Of these included significant or non- significant studies, 3 have duplicated survival data [29], [37], [70] and one has uncompleted data [53].…”

Section: Resultsmentioning

confidence: 99%

“…We next analyze the association between LVI and OS in NSCLC patients by univariate (28 studies, comprising 9,703 cases) [25], [27], [31], [33], [34], [39]–[52], [54]–[60], [62], [63] or multivariate analysis (25 studies, comprising 9,423 cases) [27], [31], [34], [39]–[42], [44], [46]–[49], [51], [54], [57], [58], [61], [63]–[69]. The pooled HR estimate was 1.97 (95% CI: 1.75–2.21; P <0.0001) by univariate analysis with a significant heterogeneity (Q = 62.17; I 2 = 51.7%, P <0.0001).…”

Section: Resultsmentioning

confidence: 99%

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Clinical Significance and Role of Lymphatic Vessel Invasion as a Major Prognostic Implication in Non-Small Cell Lung Cancer: A Meta-Analysis

Wang

Zhao

et al. 2012

PLoS ONE

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BackgroundLymphatic vessel invasion (LVI) exerts an important process in the progression and local spread of cancer cells. However, LVI as a prognostic factor for survival in non-small cell lung cancer (NSCLC) remains controversial.Methodology/Principal FindingsA meta-analysis of published studies from PubMed and EMBASE electronic databases was performed to quantity the effects of LVI on both relapse-free survival and overall survival for patients with NSCLC. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used to assess the strength of these effects. This meta-analysis included 18,442 NSCLC patients from 53 eligible studies. LVI appeared in 32.1% (median; range, 2.8% to 70.9%) of tumor samples. In all, patients with LVI were 2.48 times more likely to relapse by univariate analysis (95% CI: 1.92–3.22) and 1.73 times by multivariate analysis (95% CI: 1.24–2.41) compared with those without LVI. For the analyses of LVI and overall survival, the pooled HR estimate was 1.97 (95% CI: 1.75–2.21) by univariate analysis and 1.59 (95% CI: 1.41–1.79) by multivariate analysis. Multivariate analysis showed a risk was 91% higher for recurrence (HR = 1.91, 95% CI: 1.14–2.91) and 70% higher for mortality (HR = 1.70, 95% CI: 1.38–2.10) in LVI-positive I stage patients compared with LVI-negative I stage patients. Subgroup analyses showed similar significant adjusted risks for recurrence and death in adenocarcinomas, and a significant adjusted risk for death in studies that utilized elastic staining with or without immunohistochemistry in defining LVI.Conclusions/SignificanceThe present study indicates that LVI appears to be an independent poor prognosticator in surgically managed NSCLC. NSCLC patients with LVI would require a more aggressive treatment strategy after surgery. However, large, well-designed prospective studies with clinically relevant modeling and standard methodology to assess LVI are required to address some of these important issues.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical Significance and Role of Lymphatic Vessel Invasion as a Major Prognostic Implication in Non-Small Cell Lung Cancer: A Meta-Analysis

Wang

Zhao

et al. 2012

PLoS ONE

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“…Nine studies reported survival data for patients with stage I only 3 9 12 24–27 31 32. Analysis suggested that the association between positive pre-resection PLC and a poor survival outcome was even more pronounced in this group.…”

Section: Resultsmentioning

confidence: 99%

Positive pre-resection pleural lavage cytology is associated with increased risk of lung cancer recurrence in patients undergoing surgical resection: a meta-analysis of 4450 patients

Saso

Rao

Ashrafian

et al. 2012

Thorax

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IntroductionThe value of pleural lavage cytology (PLC) in assessing the prognosis of early stage lung cancer is still controversial. No systematic review has investigated the relationship between PLC and lung cancer recurrence. Our primary goal was to investigate the association between positive pre-resection PLC and pleural, distant and overall tumour recurrence in patients undergoing surgical resection. Methods Medline, EMBASE and Google Scholar databases were searched up to 2011. All studies reporting relevant outcomes in both patient groups were included. Data were extracted for the following outcomes of interest: overall, local and distant recurrence; and freedom from death (survivaldoverall and patients with stage I disease only). Random effects meta-analysis was used to aggregate the data. Sensitivity and heterogeneity analysis were performed. Results A meta-analysis of eight studies at maximum follow-up demonstrated a significant association between positive pre-resection PLC and increased risk of post-resection overall recurrence (OR 4.82, 95% CI 2.45 to 9.51), pleural recurrence (OR 9.89, 95% CI 5.95 to 16.44) and distant cancer recurrence (OR 3.18, 95% CI

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“…11 In addition, another of our previous reports showed that the survival and disease-free rates of patients after a lobectomy for adenocarcinomas sized 16-20 mm and containing less than 50% GGO were significantly worse than for patients who underwent wedge resection for GGO-predominant adenocarcinomas. 12 Cases with mucinous lesions were not included in the present study, because the smear sample from them contains mainly mucus and histiocytes, rarely tumor cells. In addition, a mucinous adenocarcinoma can easily spread in an aerogenous manner.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Diagnosis and Surgical Procedure with Imprint Cytology for Small Pulmonary Adenocarcinoma

et al. 2020

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Objectives: For patients with multiple small-sized pulmonary cancers, a lobectomy can disrupt future therapeutic options for other lesions. It was recently reported that limited pulmonary resections were not inferior to lobectomy for the management of selected peripheral small-sized pulmonary adenocarcinomas. Patients with adenocarcinoma in situ or minimally invasive adenocarcinoma, as proposed by the International Association for the Study of Cancer classification, have been reported to have 100% survival after 5 years. However, that classification can be applied postoperatively. Since 2005, we have been intentionally performing limited pulmonary resection procedures for small-sized adenocarcinoma cases based on intraoperative imprint cytological diagnosis and our classification (Nakayama-Higashiyama's classification). Materials and Methods: A total of 120 consecutive cases were included in this study. Lung tumors were removed intraoperatively by wedge resection, and stump smear cytology was performed, from which the cases were classified into 5 groups based on our classification. When the tumor was classified as Group I or II, the operation was finished. When diagnosed as a more advanced classification, a lobectomy and lymph node dissection were additionally performed. Results: The 5-year survival rate for Group I and II was 100%, while those for Group III and IV-V were 95.8% and 94.4%, respectively. The 5-year disease-free survival rates for Group I and Group II were 100% and 97.1%, respectively, and for Group III and IV-V they were 100% and 94.1%, respectively. Conclusion: Use of cytological findings along with Nakayama-Higashiyama's classification for determining operation procedure is effective for treatment of patients with small-sized pulmonary adenocarcinoma.

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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☆

Cited by 20 publications

References 15 publications

Clinical Significance and Role of Lymphatic Vessel Invasion as a Major Prognostic Implication in Non-Small Cell Lung Cancer: A Meta-Analysis

Clinical Significance and Role of Lymphatic Vessel Invasion as a Major Prognostic Implication in Non-Small Cell Lung Cancer: A Meta-Analysis

Positive pre-resection pleural lavage cytology is associated with increased risk of lung cancer recurrence in patients undergoing surgical resection: a meta-analysis of 4450 patients

Intraoperative Diagnosis and Surgical Procedure with Imprint Cytology for Small Pulmonary Adenocarcinoma

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