PT  - JOURNAL ARTICLE
AU  - Jinkyeong Park
AU  - Mi-Ae Kim
AU  - ChangMin Choi
AU  - HyungRyul Kim
TI  - Is surgical resection of M1a lung adenocarcinoma with metastatic pleural nodules really a useless choice?
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P4197
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P4197.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P4197.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - According to a revised 7th TNM classification of NSCLC, malignant pleural nodules are defined as a M1a stage. This study attempts to validate an effect of the surgical resection of a primary lung lesion to the survival of lung adenocarcinoma with metastatic pleural nodules which was not detected on chest CT and PET scan. From 1995 to 2010, we retrospectively investigated in 36 patients who had adenocarcinoma with metastatic pleural nodules. There were no evidences of pleural nodules on chest CT or PET/CT before surgery. Whenever unexpectedly pleural nodules were at surgery, additional surgical resection of the nodules were decided by surgeon. 36 patients of adenocarcinoma were upstaged to M1a because malignant pleural nodules found at operation. 22 patients had only “open and closure” exploratory thoracotomy (Non-Surgery group) and 14 patients had surgical resection of a primary lung adenocarcinoma (Surgery group). There were no significant differences of age and FEV1 (%) between Surgery group and Non-Surgery group. The 1-year survival rate of the total 36 patients was 92% (Non-surgery group (86%) vs. Surgery group (100%),p=0.157). The 2-year survival rate was 75% (Non-surgery group (66%) vs. Surgery group (89%), p=0.123). The 5-year survival rate was 26% (Non-surgery group (12%) vs. Surgery group (74%),p=0.011*). The median time to progression of the total 36 patients was 14.6±3.7months (Non-surgery group 4.6±1.0months vs. Surgery group 39.5±12.7months). Surgical resection of primary lung cancer would prolong the time to progression and improve the 5-year survival rate in some adenocarcinoma patients with invisible metastatic pleural nodules.