P6 Significance of minimal pleural effusion in non-small cell lung cancer
| العنوان: | P6 Significance of minimal pleural effusion in non-small cell lung cancer |
|---|---|
| المؤلفون: | S. Tsim, J Maclay, KG Blyth, GA Martin, C Stewart |
| المصدر: | Thorax. 71:A86.1-A86 |
| بيانات النشر: | BMJ, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, Pleural effusion, medicine.medical_treatment, Thoracentesis, Context (language use), medicine.disease, Surgery, Effusion, Medicine, Radiology, Stage (cooking), business, Prospective cohort study, Lung cancer, Radiation treatment planning |
| الوصف: | Introduction and objectives Recent publications report a significant survival disadvantage associated with minimal pleural effusion (MiniPE) at presentation of non-small cell lung cancer (NSCLC). MiniPE is defined when an effusion is too small for thoracentesis or where aspiration cytology is negative. Occult pleural metastases (OPM), indirect pathophysiology or comorbidity may cause MiniPE, but staging beyond thoracentesis is rarely performed. Assumption of OPM and therapeutic nihilism may contribute to poor outcomes. We assessed the prognostic impact of MiniPE in potentially radically-treatable NSCLC (Stage I-IIIA), oncologists’ attitudes to treatment planning and the final treatment delivered. Methods Electronic records and baseline imaging were reviewed retrospectively in 441 consecutive diagnoses of NSCLC made over 6 months in 2009. Stage I-IIIA patients were dichotomized into: No effusion and MiniPE. Malignant effusion (Stage IV) cases were recorded for comparison. The impact of effusion status on overall survival (OS) was estimated using Kaplan-Meier methodology. The probable cause of MiniPE was assessed indirectly using follow-up imaging/records. 3 Clinical Oncologists were surveyed for theoretical treatment plans in 8 randomly-selected MiniPE Stage I-IIIA cases based on anonymised imaging and history. These 24 plans were compared to the treatment delivered in MiniPE patients. Results 103/441 (23%) patients had MiniPE. 167/441 (38%) were Stage I-IIIA; 26/167 (16%) of these had MiniPE. OS based on effusion status (Stage I-IIIA) is shown in Figure 1. 28/103 (17%) MiniPE patients survived Conclusions These retrospective data confirm the negative prognostic impact of MiniPE and suggest the prevalence of OPM is at least 27% in Stage I-IIIA NSCLC. This is likely an underestimate given our limited data in poor prognosis patients. Radical treatment was rarely delivered despite aggressive treatment plans. A prospective study utilising thoracoscopic staging could define the true prevalence of OPM in MiniPE. Objective staging might improve decision-making, radical treatment rates and OS in this context. |
| تدمد: | 1468-3296 0040-6376 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::33f7f6019eb982b0edd0b4b1853b33d3Test https://doi.org/10.1136/thoraxjnl-2016-209333.149Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi...........33f7f6019eb982b0edd0b4b1853b33d3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14683296 00406376 |
|---|