title: Prognosis of non-small-cell lung cancer with unexpected pleural spread at thoracotomy.
abstract: BACKGROUND
  The aim of the study is to investigate the prognosis of non-small-cell lung cancer (NSCLC) with unexpected pleural spread at thoracotomy.
  
  
  METHODS
  We conducted a retrospective review of the clinicopathologic characteristics of NSCLC patients with unexpected pleural spread at thoracotomy in Taipei Veterans General Hospital between January 1990 and December 2008. Inclusion criteria were patients with frozen section of pleural nodules identified as metastatic carcinoma during operation. A survival analysis was done.
  
  
  RESULTS
  There were 138 patients included in this study. The median follow-up time was 19.9 mo. The overall 1, 3, and 5-year survival rates were 72.9%, 26.8%, and 16.6%, respectively. Multivariate analysis showed that main tumor resection and mediastinal lymph nodal involvement (P < 0.001 and 0.002, respectively) were significant predictors for overall survival rate. Patients who underwent main tumor resection and those without mediastinal lymph node metastasis had better outcomes.
  
  
  CONCLUSIONS
  Among the unexpected pleural spread detected at thoracotomy, limited pulmonary resection was an alternative surgical procedure for these patients without mediastinal nodal metastasis.
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Bing-Yen
authors.initials: BY
authors.lastname: Wang
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Wu
authors.forename: Jung-Jyh
authors.initials: JJ
authors.lastname: Hung
authors.forename: Po-Kuei
authors.initials: PK
authors.lastname: Hsu
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Hsieh
authors.forename: Chien-Sheng
authors.initials: CS
authors.lastname: Huang
authors.forename: Wen-Hu
authors.initials: WH
authors.lastname: Hsu
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010997:Pleural Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013908:Thoracotomy