title: Surgical Intervention for Non-Small-Cell Lung Cancer Patients with Pleural Carcinomatosis: Results From the Japanese Lung Cancer Registry in 2004.
abstract: BACKGROUND
  A subset of non-small-cell lung cancer (NSCLC) patients with malignant pleural effusion and/or malignant pleural nodules is now classified as stage IV and is generally considered a contraindication to surgery. However, several reports have demonstrated that the prognosis of patients with pleural carcinomatosis first detected at thoracotomy is relatively favorable. The aim of this study was to describe the results of surgical intervention in NSCLC patients with pleural carcinomatosis in Japan.
  
  
  METHODS
  In 2010, the Japanese Joint Committee of Lung Cancer Registry conducted a nationwide registration of lung cancer patients who underwent surgery in 2004. Using this database, we performed a retrospective study focused on pleural carcinomatosis. We examined the clinicopathological features, the current status of therapy, and surgical outcomes in patients with pleural carcinomatosis.
  
  
  RESULTS
  Among the 11,420 registered NSCLC patients, 329 (2.9%) patients had pleural carcinomatosis. The median survival time and 5-year survival rate of 313 patients without other metastatic disease were 34.0 months and 29.3%, respectively. Primary tumor resection was performed in 256 (81.8%) patients, and macroscopic complete resection was achieved in 152 (48.6%) patients, with 5-year survival rates of 33.1% and 37.1%, respectively. Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status (p < 0.001), best stage nodal status (p = 0.002), and the presence or absence of gross residual tumor (p = 0.013) were independent predictors of survival.
  
  
  CONCLUSIONS
  In our surgical registry for NSCLC, patients with pleural carcinomatosis accounted for 2.9%, and macroscopic complete resection for them was associated with better survival.
authors.affiliation: *Department of Thoracic Surgery, Kimitsu Central Hospital, Chiba, Japan; †Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan; ‡Department of Mathematics, Science University of Tokyo, Tokyo, Japan; §Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan; ‖Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan; ¶Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; #Department of General Thoracic Surgery, Suita Tokushukai Hospital, Osaka, Japan; **Department of Clinical Medicine, Research Institute for Diseases of the Chest, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; ††Department of Medical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan; ‡‡Division of Respiratory Disease, National Defense Medical College, Tokorozawa, Japan; §§Division of Respiratory Medicine, Juntendo University Faculty of Medicine & Graduate School of Medicine, Tokyo, Japan; and ‖‖Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Iida
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Shiba
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshino
authors.forename: Etsuo
authors.initials: E
authors.lastname: Miyaoka
authors.forename: Hisao
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authors.lastname: Asamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
authors.forename: Meinoshin
authors.initials: M
authors.lastname: Okumura
authors.forename: Hirohito
authors.initials: H
authors.lastname: Tada
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Dosaka-Akita
authors.forename: Hideo
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.forename: Kohei
authors.initials: K
authors.lastname: Yokoi
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D010997:Pleural Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012042:Registries; D015996:Survival Rate