ALC  Vol.3 No.1 , March 2014
Five-Year Survivors of Non-Small Cell Lung Cancer Patients with Positive Pleural Lavage Cytology
Abstract: Background: The pleural lavage cytology (PLC) for non-small cell lung cancer (NSCLC) patients has been reported as a significant prognostic factor. The aim of this study is to clarify the clinicopathological characteristics of 5-year survivors of patients with positive PLC. Methods: Among 401 resected NSCLC patients, 30 (7.48%) patients with positive PLC were reviewed retrospectively. Results: Only 7 of 30 patients (23.3%) survived more than 5-year. There were no differences in age, gender, histology, pT status and pN status between 5-year survivors and non-survivors. On the other hand, the serum carcinoembryonic antigen (CEA) level was significantly higher in non-survivors. Among these 5-year survivors, 4 of 7 patients died of NSCLC recurrences more than 5 years after surgery. Remaining 3 patients survived without cancer recurrences. Interestingly these 3 survivors had not received any adjuvant therapies after surgery. Conclusion: None of the 5-year survivor with positive PLC had high serum CEA level. Furthermore 5-year survival did not equal to cure in NSCLC patients with positive PLC.
Cite this paper: Tomita, M. , Ayabe, T. , Chosa, E. and Nakamura, K. (2014) Five-Year Survivors of Non-Small Cell Lung Cancer Patients with Positive Pleural Lavage Cytology. Advances in Lung Cancer, 3, 21-25. doi: 10.4236/alc.2014.31003.

[1]   Spjut, H.J., Hendrix, V.J., Ramirez, G.A. and Roper, C.L. (1958) Carcinoma Cells in Pleural Cavity Washings. Cancer, 11, 1222-1225.<1222::AID-CNCR2820110618>3.0.CO;2-U

[2]   Kondo, H., Asamura, H., Suemasu, K., Goya, T., Tsuchiya, R., Naruke, T., Yamagishi, K. and Uei, Y. (1993) Prognostic Significance of Pleural Lavage Cytology Immediately after Thoracotomy in Patients with Lung Cancer. Journal of Thoracic and Cardiovascular Surgery, 106, 1092-1097.

[3]   Higashiyama, M., Doi, O., Kodama, K., Yokouchi, H., Tateishi, R., Horai, T., Ashimura, J., Nagumo, S. and Naruse, Y. (1997) Pleural Lavage Cytology Immediately after Thoracotomy and before Closure of the Thoracic Cavity for Lung Cancer without Pleural Effusion and Dissemination: Clinicopathologic and Prognostic Analysis. Annals of Surgurgical Oncology, 4, 409-415.

[4]   Ichinose, Y., Tsuchiya, R., Yasumitsu, T., Koike, T., Yamato, Y., Nakagawa, K., Tada, H., Yokoi, K., Nagai, K. and Kase, M. (2001) Prognosis of Non-Small Cell Lung Cancer Patients with Positive Pleural Lavage Cytology after a Thoracotomy: Results of the Survey Conducted by the Japan Clinical Oncology Group. Lung Cancer, 31, 37-41.

[5]   Okada, M., Sakamoto, T., Nishio, W., Uchino, K., Tsuboshima, K. and Tsubota, N. (2003) Pleural Lavage Cytology in Non-Small Cell Lung Cancer: Lessons from 1000 Consecutive Resections. Journal of Thoracic and Cardiovascular Surgery, 126, 1911-1915.

[6]   Enatsu, S., Yoshida, J., Yokose, T., Nishimura, M., Nishiwaki, Y., Shirakusa, T. and Nagai, K. (2006) Pleural Lavage Cytology before and after Lung Resection in Non-Small Cell Lung Cancer Patients. The Annals of Thoracic Surgery, 81, 298-304.

[7]   Lim, E., Clough, R., Goldstraw, P., Edmonds, L., Aokage, K., Yoshida, J., Nagai, K., Shintani, Y., Ohta, M., Okumura, M., Iwasaki, T., Yasumitsu, T., Okada, M., Mimura, T., Tsubota, N., Nakagawa, T., Okumura, N., Satoh, Y., Okumura, S., Nakagawa, K., Higashiyama, M., Kodama, K., Riquet, M., Vicidomini, G., Santini, M., Kotoulas, C., Hsu, J.Y. and Chen, C.Y. (2010) Impact of Positive Pleural Lavage Cytology on Survival in Patients Having Lung Resection for Non-Small-Cell Lung Cancer: An International Individual Patient Data Meta-Analysis. Journal of Thoracic and Cardiovascular Surgery, 139, 1441-1446.

[8]   Saso, S., Rao, C., Ashrafian, H., Ghaem-Maghami, S., Darzi, A. and Athanasiou, T. (2010) 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. Thorax, 67, 526-532.

[9]   Tomita, M., Shimizu, T., Matsuzaki, Y., Hara, M., Ayabe, T. and Onitsuka, T. (2005) Prognostic Significance of Carcinoembryonic Antigen Level in Pleural Lavage Fluid for Patients with Lung Adenocarcinoma. The Annals of Thoracic Surgery, 80, 276-281.

[10]   Satoh, Y., Hoshi, R., Ishikawa, Y., Horai, T., Okumura, S. and Nakagawa, K. (2007) Recurrence Patterns in Patients with Early Stage Non-Small Cell Lung Cancers Undergoing Positive Pleural Lavage Cytology. The Annals of Thoracic Surgery, 83, 197-202.

[11]   Kawachi, R., Nakazato, Y., Masui, K., Takei, H., Koshi-ishi, Y. and Goya, T. (2009) Clinical Significance of Pleural Lavage Cytology for Non-Small Cell Lung Cancer: Is Surgical Resection Valid for Patients with Positive Pleural Lavage Cytology? Interactive Cardiovascular and Thoracic Surgery, 9, 265-268.

[12]   Grunnet, M. and Sorensen, J.B. (2012) Carcinoembryonic Antigen (CEA) as Tumor Marker in Lung Cancer. Lung Cancer, 76, 138-143.

[13]   Tomita, M., Shimizu, T., Hara, M., Ayabe, T. and Onitsuka, T. (2008) Serum Carcinoembryonic Antigen Level and Pleural Lavage Cytology in Woman with Non-Small Cell Lung Cancer. The Thoracic and Cardiovascular Surgeon, 56, 422-425.

[14]   Tsutani, Y., Yamashita, Y., Misumi, K., Ikeda, T., Miyata, Y. and Okada, M. (2012) Non-Small-Cell Lung Cancer Prognosis Using Carcinoembryonic Antigen Levels in Pleural Lavage Fluid. European Journal of Cardiothoracic Surgery, 42, e96-e101.

[15]   Wada, H., Fukuse, T. and Hitomi, S. (1995) Long-Term Survival of Surgical Cases of Lung Cancer. Lung Cancer, 13, 269-274.

[16]   Lee, C.K., Brown, C., Gralla, R.J., Hirsh, V., Thongprasert, S., Tsai, C.M., Tan, E.H., Ho, J.C., Chu, D.T., Zaatar, A., Osorio Sanchez, J.A., Vu, V.V., Au, J.S., Inoue, A., Lee, S.M., Gebski, V. and Yang, J.C. (2013) Impact of EGFR Inhibitor in Non-Small Cell Lung Cancer on Progression-Free and Overall Survival: A Meta-Analysis. Journal of the National Cancer Institute, 105, 595-605.