Malignant minor pleural effusion detected on thoracotomy for patients with non–small cell lung cancer: is tumor resection beneficial for prognosis?

doi:10.1016/S0003-4975(01)03426-9

The Annals of Thoracic Surgery

Volume 73, Issue 2, February 2002, Pages 412-415

https://doi.org/10.1016/S0003-4975(01)03426-9 Get rights and content

Abstract

Background. This study attempts to clarify the benefit of surgery for non–small cell lung cancer (NSCLC) with malignant minor pleural effusion that is detected at thoracotomy.

Methods. Records of surgical patients with NSCLC were reviewed, with a definition of minor pleural effusion as less than 300 mL. The patients were divided into three groups as follows: (1) group C consisted of patients who underwent grossly complete resection; group I, patients with incomplete tumor resection; and group E, patients who underwent exploratory thoracotomy only.

Results. There were 196 patients who had minor pleural effusion; of these, 96 (46%) underwent an examination to define the malignancy status of pleural effusion after surgery. In 43 patients (45%), the effusion was found to be malignant. The median survival time and 5-year survival rate, respectively, were 13 months and 9% for group C (n = 11); 34 months and 10% for group I (n = 14; p = 0.3); and 17 months and 0% for group E (n = 18; p = 0.8).

Conclusions. Tumor resection is not beneficial for the survival of patients with NSCLC who have a minor malignant pleural effusion.

Section snippets

Material and methods

We reviewed the records of surgical patients with NSCLC who had undergone surgery at any of the 14 Japanese national referral hospitals between 1980 and 1994. Entry criteria were as follows: (1) pleural effusion was not detected or suspected before surgery and the volume was less than 300 mL; (2) its malignant status was examined; and (3) follow-up was carried out for more than 5 years.

To assess whether surgical resection is beneficial for patients with malignant minor pleural effusion without

Results

There were 196 patients with minor pleural effusion (< 300 mL) at the time of thoracotomy; of these, however, 100 patients (51%) were not examined for malignancy status. Among the remaining 96 patients, all specimens were postoperatively examined to determine malignancy status. There were 43 patients (45%) with malignant minor pleural effusion of which 4 cases (9%) were bloody. Histologic diagnosis was adenocarcinoma in 38 cases, squamous cell carcinoma in 4, and large cell carcinoma in 1.

Comment

In the database used to develop the 1974 lung cancer staging system, nonsurgical patients with pleural effusion were found to have an especially poor prognosis [7]. In the 1986 staging revision, pleural effusion was classified as a T4 disease, suggesting a more favorable outcome for these patients than for those with M1 disease [5]. This classification remained unchanged in the 1997 revision [4]. Recently, Sugiura and colleagues [8] compared the survival of 197 patients with stage IIIB without

Acknowledgements

We appreciate the cooperation of the members of The Japan National Chest Hospital Study Group for Lung Cancer: Yuka Fijita, MD (North Hokkaidou National Hospital); Tatsuo Saito, MD, and Osamu Kawashima, MD (Gunma-Nishi National Hospital); Toshimasa Tuchiya, MD, Tatsuhiko Hirono, MD, and Yasuhiro Watanabe, MD (Nigata-Nishi National Central Hospital); Yoshinori Hiramatsu, MD (Chubu National Hospital); Tadashi Maeda, MD, and Shigeki Makihara, MD (Sannyousou National Hospital); Takakazu Fukushima,

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Forty-three patients with lung adenocarcinoma with pleural seeding diagnosed unexpectedly during surgery performed between January 2006 and December 2014 were included in this retrospective study using a prospectively collected lung cancer database. Each surgeon decided whether to perform main tumor resection or pleural biopsy alone.
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Original article: general thoracicMalignant minor pleural effusion detected on thoracotomy for patients with non–small cell lung cancer: is tumor resection beneficial for prognosis?

Abstract

Section snippets

Material and methods

Results

Comment

Acknowledgements

J Thorac Cardiovasc Surg

Chest

Chest

J Thorac Cardiovasc Surg

J Thorac Cardiovasc Surg

Ann Thorac Surg

Ann Thorac Surg

Lung Cancer

Chest

Results of surgical treatment of patients with T3 non–small cell lung cancer

Ann Thorac Surg

Original article: general thoracic
Malignant minor pleural effusion detected on thoracotomy for patients with non–small cell lung cancer: is tumor resection beneficial for prognosis?