Does the Amount of Malignant Pleural Effusion affect the Survival in Patients with Non-small Cell Lung Cancer?Shota Nakamura1*, Takayuki Fukui1, Koji Kawaguchi1, Toshiki Okasaka1, Koichi Fukumoto2, Tetsunari Hase2, Yoshinori Hasegawa2, Akihiro Hirakawa3 and Kohei Yokoi1
- *Corresponding Author:
- Shota Nakamura
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine
65 Tsurumai-cho Showa-ku, Nagoya 466-8550, Japan
E-mail: [email protected]
Received date: Aug 11, 2016; Accepted date: Sep 09, 2016; Published date: Sep 16, 2016
Citation: Nakamura S, Fukui T, Kawaguchi K, Okasaka T, Fukumoto K, et al. (2016) Does the Amount of Malignant Pleural Effusion affect the Survival in Patients with Non-small Cell Lung Cancer?. J Lung Cancer Diagn Treat 1:106.
Copyright: © 2016 Nakamura S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: Malignant pleural effusion (MPE) in patients with non-small cell lung cáncer (NSCLC) is uniformly classified as M1a/stage IV disease in the current TNM classification, irrespective of its amount, and it is considered to be an incurable disease condition. Although a small amount of MPE had been reported to be an early phase of pleural carcinomatosis, its clinical relevance has rarely been studied. In this study, we examined the influence of the amount of MPE on the survival of patients with NSCLC. Materials and Methods: Sixty patients with pleural carcinomatosis referred to our institution between 2005 and 2012 were enrolled. The patients were classified into three groups according to the amount of MPE on chest computed tomography (CT): E0, no MPE (n=21); E1, a small amount of MPE (<1.0 cm thick on CT, n=19); and E2, a large amount of MPE (≥1.0 cm thick on CT, n=20). The association between the clinicopathological factors, including the amount of MPE, and the survival were investigated using univariate and multivariate analyses. Results: The patients with E2 had significantly shorter survivals than the E0 and E1 groups (median survival of 16, 31, and 20 months, respectively; log-rank test, P<0.01), while there was no significant difference between the E0 and E1 groups. In the multivariate analysis, histology, EGFR gene mutation status, and the amount of MPE remained significant prognostic factors. Conclusion: The amount of MPE in NSCLC might be an important prognostic factor and affect patient survival. In the TNM classification, the amount of MPE should be considered for inclusion in the definition of T descriptor or stage grouping.