Author of

• 10643

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  P1.07 - Poster Session 1 - Surgery (ID 184)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

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    P1.07-017 - Prognostic impact of cytoreductive surgery for non-small cell lung cancer with malignant pleural effusion detected at surgery (ID 1390)

    09:30 - 16:30  |  Author(s): Y. Taniguchi
    • Abstract

    Background
    Malignant cells in the pleural effusion are classified as stage Ⅳ in the 7th edition of the TNM-staging of lung cancer. The prognosis of non-small cell lung cancer patients with malignant pleural effusion is reported to be poor as the patients with malignant pleural effusion are generally not subjected to surgery. However, clinically relevant question whether or not the primary tumor should be resected when malignant pleural effusion is first detected at thoracotomy, is controversial. Our purpose is to address the role of surgical resection for main tumor in such patients.

    Methods
    A retrospective review was conducted with clinical charts of 155 patients with non-small cell lung cancer who had pleural effusion detected at radical surgery between January 2006 and December 2012 at Kansai Medical University Hirakata Hospital. We compared prognosis of the patients with or without surgical tumor resection.

    Results
    Of the 155 patients with pleural effusion, 30 patients had malignant cells and 125 did not. Of the 30 patients, 18 were men and 12 were women. Twenty-five tumors were adenocarcinoma, 3 were large-cell neuroendocrine carcinoma, 1 was small cell carcinoma and 1 was squamous cell carcinoma. Seven patients were treated with lobectomy, 12 were treated with wedge resection and 11 were with exploratory thoracotomy. Five-year survival rate was 35.0% in patients with primary tumor resection, whereas none of the patients without surgical resection of tumors survived 5 years. Two-year survival rate was 22.7% in patients with exploratory thoracotomy.

    Conclusion
    The prognosis of patients with malignant pleural effusion detected at surgery was not such poor compared to that of generally reported stage IV patients. Patients with surgical resection of main tumor showed better survival compared to those without surgical resection, suggesting that cytoreductive surgery contributed to multimodality treatment in patients with malignant pleural effusion. Based on our series of patients, status of N0 may be candidates for primary tumor resection even in patients with malignant pleural effusion.