ArticleSurgery today2026
Serial changes in pleural lavage cytology during lung cancer surgery predict recurrence and pleural dissemination.
Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Value of RASSF1A and SHOX2 methylation detection in intraoperative pleural lavage fluid for potential microdissemination and prognosis evaluation in non-small cell lung cancer.World journal of surgical oncology · 2026Article
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10 authors.
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Abstract
purposePleural lavage cytology (PLC) is a recognized prognostic marker in non-small cell lung cancer (NSCLC); however, the impact of serial intraoperative changes remains unclear.
methodsWe retrospectively analyzed 439 patients who underwent curative NSCLC resection. PLC was performed at three intraoperative points: after thoracotomy (pre-PLC), after lung resection, and after lavage at chest closure (post-PLC). Associations between recurrence-free survival (RFS) and pleural dissemination were evaluated by a Kaplan-Meier analysis and Fine and Gray competing risks regression.
resultsForty-one patients had at least one positive PLC result. RFS was the lowest in pre-PLC( +)/post-PLC( +) (n = 10), intermediate in pre-PLC(-)/post-PLC( +) (n = 11), and best in post-PLC( -) (n = 20). Importantly, post-PLC( -) patients included 13 patients with pre-PLC positivity, yet their RFS matched that of consistently negative cases (n = 398). The cumulative incidence of pleural dissemination exhibited a similar pattern. In a multivariate analysis, post-PLC positivity, but not pre-PLC positivity, independently predicted poor RFS (hazard ratio, 3.06; p < 0.001).
conclusionPost-PLC, but not pre-PLC, provides decisive prognostic information for recurrence and pleural dissemination, likely reflecting residual lavage-resistant tumor clusters. Importantly, combining pre- and post-PLC results refines risk stratification and identifies the poorest-outcome subgroup that may benefit from adjuvant therapy.
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