Prognosis of non-small-cell lung cancer with unexpected pleural spread at thoracotomy

The aim of the study is to investigate the prognosis of non-small-cell lung cancer (NSCLC) with unexpected pleural spread at thoracotomy.

We conducted a retrospective review of the clinicopathologic characteristics of NSCLC patients with unexpected pleural spread at thoracotomy in Taipei Veterans General Hospital between January 1990 and December 2008. Inclusion criteria were patients with frozen section of pleural nodules identified as metastatic carcinoma during operation. A survival analysis was done.

There were 138 patients included in this study. The median follow-up time was 19.9 mo. The overall 1, 3, and 5-year survival rates were 72.9%, 26.8%, and 16.6%, respectively. Multivariate analysis showed that main tumor resection and mediastinal lymph nodal involvement (P < 0.001 and 0.002, respectively) were significant predictors for overall survival rate. Patients who underwent main tumor resection and those without mediastinal lymph node metastasis had better outcomes.

Among the unexpected pleural spread detected at thoracotomy, limited pulmonary resection was an alternative surgical procedure for these patients without mediastinal nodal metastasis.