VOLUME 30 - NUMBER 51 - 2009

La citologia su lavaggio pleurico come fattore prognostico nel carcinoma polmonare non a piccole cellule

  • Mazza F., Baldo S., Percivale A., Lupi P., Maineri P., De Cian F., Pennati S., Barraco A., Natale C., Ferrari E., Pellicci R.
  • Articolo Originale, 209-213
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  • Objective: The aim of our study was to assess the prognostic value of Pleural Lavage Cytology in patients undergoing pulmonary resections for NSCLC. Methods: From January 2003 to July 2006 we performed PLC on 191 consecutive operable NSCLC without macroscopic pleural effusion. PLC was carried out soon after thoracotomy and before any lung manipulation, through the instillation of saline solution in the pleural cavity. PLC outcomes and patients clinicopathologic data were collected to evaluate their impact on prognosis. Results: In our series PLC was positive in 8 patients (4,2%): positive finding were related to histological diagnosis of adenocarcinoma (p = 0,01), grading G3-4 (p = 0,036), local infiltration as pT3-4 (p< 0,001), nodal dissemination as pN2-3 (p = 0,016) and number of involved lymphatic stations (p = 0,001). The 5-years survival rates were 37% in the positive group and 29% in the negative (p = 0,629), furthermore we observed a cancer recurrence rate of 37,5% in patients with positive PLC versus 6,3% in negative (p = 0,001). In the positive group cancer progressions were commonly local recurrences (25% vs 4% of negative) and cerebral metastasis (12,5% vs 0,5% of negative, p <0,000). Conclusions:We found that PLC has a small impact on survival, it is however a good prognostic factor in predict cancer recurrence.

  • KEY WORDS: pleural space, survival, lung cancer, pleural lavage cytology, prognosis.