Ogawa Hiroyuki, Uchino Kazuya, Tanaka Yugo, Shimizu Nahoko, Okuda Yusuke, Tane Kenta, Tauchi Shunsuke, Nishio Wataru, Maniwa Yoshimasa, Yoshimura Masahiro
Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-city, Hyogo, Japan Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-city, Hyogo, Japan
Interact Cardiovasc Thorac Surg. 2015 Jul;21(1):34-9. doi: 10.1093/icvts/ivv098. Epub 2015 Apr 23.
Positive pleural lavage cytology (PLC) findings are considered to be predictive of a poor prognosis in patients with non-small-cell lung cancer (NSCLC). We investigated the clinical benefit of adjuvant chemotherapy for lung adenocarcinoma patients with positive PLC findings.
We retrospectively reviewed the medical records of lung adenocarcinoma patients who underwent tumour resection and had positive PLC findings between January 2000 and December 2009.
Fifty-three patients (4.8%) of 1114 patients with lung adenocarcinoma had positive PLC findings. The median follow-up period was 33.6 months. Adjuvant chemotherapy was administered to 24 patients (adjuvant chemotherapy group); 7, 8 and 9 patients had pathological Stage I, II and III, respectively . The surgery-alone group comprised 29 patients; 12, 8 and 9 patients had pathological Stage I, II and III, respectively. The 5-year recurrence-free survival (RFS) rates were 34.6 and 15.7% (P < 0.01) in adjuvant chemotherapy and surgery-alone groups, respectively. The rate of distant recurrence was significantly reduced in the adjuvant chemotherapy group (25.0 and 58.6%; P = 0.01). Even for Stage I cases, adjuvant chemotherapy tended to improve the 5-year RFS rate compared with surgery alone (60.1 and 29%; P = 0.11). Multivariate analysis for RFS revealed that adjuvant chemotherapy [hazard ratio (HR), 0.45; P = 0.03], tumour size >30 mm (HR, 2.23; P = 0.02) and lymph node metastasis (HR, 2.67; P < 0.01) were significant independent prognostic factors for recurrence.
Adjuvant chemotherapy for lung adenocarcinoma patients with positive PLC findings significantly improved recurrence-free survival.
在非小细胞肺癌（NSCLC）患者中，阳性胸腔灌洗细胞学检查（PLC）结果被认为可预测预后不良。我们研究了辅助化疗对PLC结果为阳性的肺腺癌患者的临床益处。
我们回顾性分析了2000年1月至2009年12月期间接受肿瘤切除且PLC结果为阳性的肺腺癌患者的病历。
1114例肺腺癌患者中有53例（4.8%）PLC结果为阳性。中位随访期为33.6个月。24例患者接受了辅助化疗（辅助化疗组）；其中7例、8例和9例患者分别处于病理I期、II期和III期。单纯手术组包括29例患者；其中12例、8例和9例患者分别处于病理I期、II期和III期。辅助化疗组和单纯手术组的5年无复发生存率（RFS）分别为34.6%和15.7%（P<0.01）。辅助化疗组的远处复发率显著降低（25.0%和58.6%；P=0.01）。即使对于I期病例，与单纯手术相比，辅助化疗也倾向于提高5年RFS率（60.1%和29%；P=0.11）。RFS的多因素分析显示，辅助化疗[风险比（HR），0.45；P=0.03]、肿瘤大小>30mm（HR，2.23；P=0.02）和淋巴结转移（HR，2.67；P<0.01）是复发的重要独立预后因素。
对于PLC结果为阳性的肺腺癌患者，辅助化疗显著改善了无复发生存率。
