Role of surgery in multi-modality treatment for carcinomatous pleuritis in patients with non-small cell lung cancer.

Abstract

OBJECTIVE:

To evaluate the role of surgery in the treatment of the patients with non-small cell lung cancer with pleural dissemination.

METHODS:

The clinical records of 25 patients (mean age 69 years) diagnosed with carcinomatous pleuritis during a thoracotomy by pathological examination and followed by surgery between 1994 and 2012 were reviewed. The treatment modality, including surgery, the clinicopathologic characteristics and 5-year survival were analyzed.

RESULTS:

There were 16 adenocarcinomas, 6 squamous cell carcinomas and 3 large cell carcinomas. Surgery included resection of the main tumor by partial resection in 10 cases, segmentectomy in 2 cases, lobar resection in 12 cases and bilobectomy in 1 case. Intrathoracic irrigation was performed in 20 cases. The pathological N status was N0/N1/N2/Nx: 10/6/7/2. Fifteen patients received adjuvant therapy. The overall 5-year survival rate was 22.2 %. The 5-year survival rates of the N0, N1 and N2 groups were 36.0, 16.7 and 14.3 %, respectively (p = 0.0068). Nine patients lived more than 3 years including 5 in N0, 3 in N1 and 1 in N2.

CONCLUSIONS:

Surgery should not be excluded from the multi-modality treatment of patients with carcinomatous pleuritis because there are some patients who could benefit from surgery especially if they are in N0 status.

• Authors: Tetsuhiko Go, Noriyuki Misaki, Natsumi Matsuura, Sung Soo Chang, Shintarou Tarumi, Hiroyasu Yokomise
• Journal: Surgery today (Surg Today) Vol. 45 Issue 2 Pg. 197-202 (Feb 2015) ISSN: 1436-2813 [Electronic] Japan
• PMID: 25034395 (Publication Type: Journal Article)

Topics

• Aged
• Carcinoma, Non-Small-Cell Lung (complications, mortality, pathology, therapy)
• Combined Modality Therapy
• Female
• Humans
• Lung Neoplasms (complications, mortality, pathology, therapy)
• Male
• Middle Aged
• Neoplasm Staging
• Pleura (surgery)
• Pleural Effusion, Malignant (etiology, surgery)
• Pleurisy (etiology, surgery)
• Pneumonectomy
• Prognosis
• Retrospective Studies
• Survival Rate