title: Pleural lavage cytology predicts recurrence and survival, even in early non-small cell lung cancer.
abstract: OBJECTIVE
  The TNM staging remains the best prognostic descriptor of lung cancer; however, new independent prognostic factors are needed, particularly for early stage disease.
  
  
  METHODS
  An evaluation of the pleural lavage cytology (PLC) was performed in 436 consecutive NSCLC patients who underwent surgical resection; clinical, pathological and follow-up data were available for 414 patients.
  
  
  RESULTS
  The PLC was positive in 15 patients (3.6 %). The overall five-year survival was 35.9 % in PLC-positive and 57.8 % in PLC-negative patients (p = 0.004). To compare groups with the same prognostic characteristics, the analysis was restricted to p-stage I patients, but the survival remained worse in the PLC-positive patients (42.9 vs 69.4 %; p = 0.001). Recurrence was also observed more frequently in PLC-positive cases: 69.2 vs 34.5 %, OR 4.28 (95 % CI 1.29-14.18; p = 0.01). Among the PLC-positive patients, no difference between the local (44.4 %) and distant (55.6 %) relapse patterns was found (p = 0.82). The multivariate analysis identified four independent prognostic factors: age (p < 0.001), disease stage (p < 0.001), gender (p = 0.025) and PLC status (p = 0.012).
  
  
  CONCLUSIONS
  PLC is an independent prognostic factor for NSCLC. PLC-positive NSCLC patients have a worse overall survival and a higher recurrence rate, even in stage I disease. PLC-positive patients should be considered a high risk category, who should potentially be eligible for adjuvant therapy regardless of their p-stage.
authors.affiliation: Thoracic Surgery Unit, Santa Corona Hospital, Via XXV Aprile 38, 17027, Pietra Ligure, SV, Italy, mazza-federico@libero.it.
authors.forename: Federico
authors.initials: F
authors.lastname: Mazza
authors.forename: Enrico
authors.initials: E
authors.lastname: Ferrari
authors.forename: Paola
authors.initials: P
authors.lastname: Maineri
authors.forename: Beatrice
authors.initials: B
authors.lastname: Dozin
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Ratto
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D003581:Cytodiagnosis / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D011379:Prognosis; D015996:Survival Rate