Efficacy of adjuvant chemotherapy for lung adenocarcinoma patients with positive pleural lavage cytology findings
Efficacy of adjuvant chemotherapy for lung adenocarcinoma patients with positive pleural lavage cytology findings
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胸腔灌洗细胞学阳性肺腺癌患者辅助化疗的疗效
DOI：
10.1093/icvts/ivv098
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Yoshimura M
中科院分区：
文献类型：
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作者：
Ogawa H;Uchino K;Tanaka Y;Shimizu N;Okuda Y;Tane K;Tauchi S;Nishio W;Maniwa Y;Yoshimura M
胸膜灌洗细胞学（PLC）阳性被认为是非小细胞肺癌（NSCLC）患者预后不良的预测指标。我们调查了辅助化疗的临床效益肺腺癌患者阳性PLC finders.METHODSWe回顾性分析了2000年1月至2009年12月的肺腺癌患者进行肿瘤切除术，并有阳性PLC结果的病历。中位随访期为33.6个月。24例患者接受辅助化疗（辅助化疗组）;病理I期、II期和III期患者分别为7例、8例和9例。单纯手术组包括29例患者;分别有12、8和9例患者的病理分期为I、II和III期。辅助化疗组和单纯手术组的5年无复发生存率分别为34.6%和15.7%（P< 0.01）。辅助化疗组的远处复发率显著降低（25.0%和58.6%;P= 0.01）。即使对于I期病例，与单纯手术相比，辅助化疗倾向于改善5年RFS率（60.1%和29%;P= 0.11）。RFS的多变量分析显示，辅助化疗[风险比（HR），0.45;P= 0.03]、肿瘤大小>30 mm（HR，2.23;P= 0.02）与淋巴结转移（HR，2.67; P< 0.01）是影响复发的独立预后因素。自由生存。
OBJECTIVESPositive 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.METHODSWe retrospectively reviewed the medical records of lung adenocarcinoma patients who underwent tumour resection and had positive PLC findings between January 2000 and December 2009.RESULTSFifty-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.CONCLUSIONSAdjuvant chemotherapy for lung adenocarcinoma patients with positive PLC findings significantly improved recurrence-free survival.