Impact of Pleural Lavage Cytology Positivity on Early Recurrence After Surgery for Non-Small Cell Lung Cancer

• José Luis Recuero Díaz ^[1] ; Sonia Gatius Caldero ^[2] ; Joel Rosado Rodríguez ^[9] ; Verónica Caamaño Villaverde ^[10] ; David Gómez de Antonio ^[3] ; Eva Tejerina ^[3] ; Laura Sánchez Moreno ^[4] ; María Martino González ^[4] ; Milagros Moldes Rodríguez ^[5] ; Ihab Abdulkader Nallibl ^[5] ; Elena Ramírez Gil ^[6] ; Irene Amat Villegas ^[6] ; Marta Genovés Crespo ^[7] ; Rubén García Ángel ^[7] ; Cora Sampedro Salinas ^[2] ; Santiago Figueroa Almánzar ^[8] ; Amparo Compañ Quilis ^[8] ; Roser Saumench Perramon ^[11] ; Guadalupe González Pont ^[12] ; Íñigo Royo Crespo ^[1] ; José M. Porcel ^[2] ; Paula Gambó Grasa ^[1] ; José Luis García Fernández ^[13] ; José Antonio Jiménez Heffernan ^[14] ; José Cerón Navarro ^[15] ; Mireia Prieto Rodríguez ^[16]
  1. [1] Hospital Miguel Servet

     Hospital Miguel Servet

     Zaragoza, España

     
  2. [2] Hospital Universitario Arnau de Vilanova

     Hospital Universitario Arnau de Vilanova

     Lérida, España

     
  3. [3] Hospital Universitario Puerta de Hierro

     Hospital Universitario Puerta de Hierro

     Madrid, España

     
  4. [4] Hospital Universitario Marqués de Valdecilla

     Hospital Universitario Marqués de Valdecilla

     Santander, España

     
  5. [5] Complexo Hospitalario Universitario de Santiago

     Complexo Hospitalario Universitario de Santiago

     Santiago de Compostela, España

     
  6. [6] Hospital Universitario de Navarra

     Hospital Universitario de Navarra

     Pamplona, España

     
  7. [7] Complejo Hospitalario Universitario de Albacete

     Complejo Hospitalario Universitario de Albacete

     Albacete, España

     
  8. [8] Hospital Clinico Universitario de Valencia

     Hospital Clinico Universitario de Valencia

     Valencia, España

     
  9. [9] Department of Thoracic Surgery, Hospital Universitario de Cruces, Barakaldo, Spain
  10. [10] Department of Pathology, Hospital Universitario de Cruces, Barakaldo, Spain
  11. [11] Department of Thoracic Surgery, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona
  12. [12] Department of Pathology, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona
  13. [13] Department of Thoracic Surgery, Hospital de La Princesa, Madrid
  14. [14] Department of Pathology, Hospital de La Princesa, Madrid
  15. [15] Department of Thoracic Surgery, Hospital Universitario y Politécnico La Fe, Valencia
  16. [16] Department of Pathology, Hospital Universitario y Politécnico La Fe, Valencia

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• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 60, Nº. 3, 2024, págs. 133-142
• Idioma: inglés
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• Resumen

  • Objective The aim of this study was to elucidate the impact of pleural lavage cytology positivity on early recurrence in patients operated on non-small cell lung cancer (NSCLC).

    Methods This is a multicentre prospective cohort study of 684 patients undergoing an anatomical lung resection for NSCLC between October 2015 and October 2017 at 12 national centres. A pleural lavage was performed before and after lung resection. The association between the different predictors of early recurrence and PLC positivity was performed using univariate and multivariate logistic regression models. A propensity score analysis was performed by inverse probability weighting (IPSW) using average treatment effect (ATE) estimation to analyse the impact of PLC positivity on early recurrence.

    Results Overall PLC positivity was observed in 15 patients (2.2%). After two years, 193 patients (28.2%) relapsed, 182 (27.2%) with a negative PLC and 11 (73.3%) with a positive PLC (p < 0.001). Factors associated to early recurrence were adenocarcinoma histology (OR = 1.59, 95%CI 1.06–2.38, p = 0.025), visceral pleural invasion (OR = 1.59, 95%CI 1.04–2.4, p = 0.03), lymph node involvement (OR = 1.84, 95%CI 1.14–2.96, p = 0.013), advanced pathological stage (OR = 2.12, 95%CI 1.27–3.54, p = 0.004) and PLC positivity (OR = 4.14, 95%CI 1.25–16.36, p = 0.028). After IPSW, PLC positivity was associated with an increased risk of early recurrence (OR = 3.46, 95%CI 2.25–5.36, p < 0.001).

    Conclusions Positive pleural lavage cytology was found to be the strongest predictor of early recurrence.