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Vol. 60. Issue 3.
Pages 133-142 (March 2024)
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Vol. 60. Issue 3.
Pages 133-142 (March 2024)
Original article
Impact of Pleural Lavage Cytology Positivity on Early Recurrence After Surgery for Non-Small Cell Lung Cancer
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José Luis Recuero Díaza,
Corresponding author
jl_recuero@hotmail.com

Corresponding author.
, Sonia Gatius Calderob, Joel Rosado Rodríguezc, Verónica Caamaño Villaverded, David Gómez de Antonioe, Eva Tejerinaf, Laura Sánchez Morenog, María Martino Gonzálezh, Milagros Moldes Rodríguezi, Ihab Abdulkader Nallibj, Elena Ramírez Gilk, Irene Amat Villegasl, Marta Genovés Crespom, Rubén García Ángeln, Cora Sampedro Salinaso, Santiago Figueroa Almánzarp, Amparo Compañ Quilisq, Roser Saumench Perramonr, Guadalupe González Ponts, Íñigo Royo Crespoa..., Paula Gambó Grasat, José Luis García Fernándezu, José Antonio Jiménez Heffernanv, José Cerón Navarrow, Mireia Prieto Rodríguezx, José M. PorcelyVer más
a Department of Thoracic Surgery, Hospital Universitario Miguel Servet, Zaragoza, IIS Aragón, Spain
b Department of Pathology, Hospital Universitario Arnau de Vilanova, Lleida, Spain
c Department of Thoracic Surgery, Hospital Universitario de Cruces, Barakaldo, Spain
d Department of Pathology, Hospital Universitario de Cruces, Barakaldo, Spain
e Department of Thoracic Surgery, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
f Department of Pathology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
g Department of Thoracic Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain
h Department of Pathology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
i Department of Thoracic Surgery, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
j Department of Pathology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
k Department of Thoracic Surgery, Hospital Universitario de Navarra, Pamplona, Spain
l Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
m Department of Thoracic Surgery, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
n Department of Pathology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
o Department of Thoracic Surgery, Hospital Universitario Arnau de Vilanova, Lleida, Spain
p Department of Thoracic Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain
q Department of Pathology, Hospital Clínico Universitario de Valencia, Valencia, Spain
r Department of Thoracic Surgery, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
s Department of Pathology, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
t Department of Pathology, Hospital Universitario Miguel Servet, Zaragoza, Spain
u Department of Thoracic Surgery, Hospital de La Princesa, Madrid, Spain
v Department of Pathology, Hospital de La Princesa, Madrid, Spain
w Department of Thoracic Surgery, Hospital Universitario y Politécnico La Fe, Valencia, Spain
x Department of Pathology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
y Pleural Medicine Unit, Department of Internal Medicine, Hospital Universitario Arnau de Vilanova, Lleida, IRBLleida, Spain
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Tables (5)
Table 1. Main characteristics of the study population according to PLC positivity.
Table 2. Univariate and multivariate analysis of factors related to PLC positivity.
Table 3. Univariate and multivariate analysis of factors related to early recurrence.
Table 4. Multivariate analysis of variables related to early recurrence after propensity score analysis using IPSW with ATE estimator.
Table 5. Factors associated with positivity in PLC in the literature.
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Abstract
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.

Keywords:
Pleural lavage cytology
Early recurrence
Non-small cell lung cancer
Thoracic Surgery
Prognostic factors
Lung cancer staging
Abbreviations:
AIC
ATE
CB
CI
GEELP
IPLCC
IPSW
NSCLC
OR
PET
PLC
ROC
SD
SECT
SMD
SUV
VATS

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