Περίληψη:
Although a malignant pleural effusion is considered a manifestation of
an advanced stage disease not amenable to curative resection in patients
with non-small cell lung cancer, the same is not true in the case of the
presence of malignant cells in the pleural cavity without an
accompanying effusion, discovered incidentally during the operation with
pleural lavage cytology (PLC). PLC is a diagnostic technique used to
detect tumor cells and translate this finding to a prognostic index.
Various reports have attempted to utilize the results of PLC and draw
inferences regarding the origins of malignant cells in the pleural
cavity, the association of these results with various disease
characteristics and, most importantly, their impact on disease
recurrence and survival. However, due to non-consistent techniques and
protocols used to acquire the samples for cytological evaluation and
assess their significance, results are inhomogeneous. Nevertheless, the
entrance of malignant cells in the pleural cavity follows the rules
posed by the natural disease process when discovered before pulmonary
resection takes place, while surgical manipulations certainly play an
important role in the case malignant cells are checked over after
pulmonary resection. In addition, although the prognostic significance
of a positive PLC result is indisputable and significantly decreases
long-term survival in the majority of studies, this factor has not yet
been incorporated into the TNM staging system. Lastly, some authors have
advocated the use of some form of adjuvant treatment for those patients
found with positive PLC results, based on the assumption that a curative
resection followed by multiple pleural washings will not remove the
entirety of the population of malignant cells present in the pleural
space. (C) 2013 Published by Elsevier Ireland Ltd.
Συγγραφείς:
Toufektzian, Levon
Sepsas, Evangelos
Drossos, Vasileios and
Gkiozos, Ioannis
Syrigos, Konstantinos
