Efficacy of adjuvant chemotherapy for lung adenocarcinoma patients with positive pleural lavage cytology findings.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
Adjuvant chemotherapy for lung adenocarcinoma patients with positive PLC findings significantly improved recurrence-free survival.
Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-city, Hyogo, Japan Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
Hiroyuki
H
Ogawa
Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-city, Hyogo, Japan kazuya-uchino@hp.pref.hyogo.jp.
Kazuya
K
Uchino
Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
Yugo
Y
Tanaka
Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-city, Hyogo, Japan.
Nahoko
N
Shimizu
Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-city, Hyogo, Japan.
Yusuke
Y
Okuda
Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-city, Hyogo, Japan.
Kenta
K
Tane
Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
Shunsuke
S
Tauchi
Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-city, Hyogo, Japan.
Wataru
W
Nishio
Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
Yoshimasa
Y
Maniwa
Department of Thoracic Surgery, Hyogo Cancer Center, Akashi-city, Hyogo, Japan Department of Thoracic Surgery, Kobe University Hospital, Kobe-city, Hyogo, Japan.
Masahiro
M
Yoshimura
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D003581:Cytodiagnosis / Q000379:methods*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D035422:Pleural Cavity / Q000473:pathology*; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D007507:Therapeutic Irrigation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
Adjuvant chemotherapy; Lung cancer; Pleural lavage cytology; Surgery