The influence of enhanced postoperative inflammation by the intrapleural administration of streptococcal preparation (OK-432) on the prognosis of completely resected non-small-cell lung cancer.
OBJECTIVE
It is not clear whether postoperative inflammation affects the prognosis of malignant disease.


METHODS
We retrospectively reviewed the patients with non-small-cell lung cancer who underwent a complete resection at the National Kyushu Cancer Center from 1989 to 1996. For the treatment of prolonged air leakage after a pulmonary lobectomy, 25 patients received an intrapleural injection of OK-432, a lyophilized preparation of the heat- and penicillin-treated Su-strain of the Streptococcus pyogenes group A3. All patients were males who were older than 50 years of age. As a control, we selected 164 male patients who were older than 50 years of age and not given OK-432 during the same period.


RESULTS
The administration of OK-432 in most patients was performed on the 4th day after the operation. Pleural drainage could be terminated in a mean of 5.5 days after the intrapleural administration of OK-432. In the control group, the serum C-reactive protein (CRP) level reached a peak on day 4 after the operation and returned to almost a normal level on day 14 after the operation. In the OK-432 group, the peak CRP level, which was significantly higher than that in the control group, was observed on day 7 after the operation and the elevated CRP level was maintained until 28 days after the operation. The mean level of CRP in the OK-432 group was significantly higher than that in the control on days 7, 14, and 28 after the operation. No significant difference was observed in the disease-free survivals between the two groups.


CONCLUSIONS
Based on the above findings, postoperative prolonged inflammation does not seem to affect the progression of subclinically residual tumor cells.
Uehara
T
T
Department of Chest Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
Yano
T
T
Kuninaka
S
S
Yoshino
I
I
Asoh
H
H
Ichinose
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery* / Q000628:therapy*; D018572:Disease-Free Survival; D006801:Humans; D007249:Inflammation / Q000473:pathology; D007267:Injections; D008175:Lung Neoplasms / Q000601:surgery* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010844:Picibanil / Q000008:administration & dosage*; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies
D000970:Antineoplastic Agents; D010844:Picibanil