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KMID : 0364020070400020109
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Korean Journal of Thoracic and Cardiovascular Surgery
2007 Volume.40 No. 2 p.109 ~ p.113
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Prognostic Factors of Malignant Pleural Effusion in Non-small Cell Lung Cancer
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Lee Hyeon-Jae
Lim Chang-Young
Lee Gun
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Abstract
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Background: In non-small cell lung cancer (NSCLC), malignant pleural effusion is a frequently observed complication, and is an important negative prognostic factor. Although many studies concerned to diagnosis and treatment of malignant pleural effusion have been performed, prognostic factors of malignant pleural effusion have rarely been investigated. This study was performed to determine the prognostic factors of malignant pleural effusion in non-small cell lung cancer.
Materials & Methods: We evaluated 33 NSCLC patients with malignant effusion treated between January 2002 and December 2003. We analyzed possible factors: gender, age, TNM Stage, fluid analysis (pH, CEA, LDH, glucose, albumin) and treatment modality. Median survival time of each factor was calculated by Kaplan-Meier method and difference of median survival time between groups of factor compared by log-rank test. The Cox proportional hazards regression model was used to confirm the significance of prognostic factor.
Results: Of the 33 patients, 23 (69.7%) patients were adenocarcinoma. The median interval of the diagnosis of lung cancer and malignant effusion was 7.3 months (25th∼75th: 3.9∼11.8), and the median survival time was 3.6 months (95% Confidence Interval: 1.14∼5.99). In the univariate analysis, using the log-rank test, those with an adenocarcinoma showed a relatively longer median survival time than those of a non-adenocarcinoma (4.067 vs. 1.867 months, p=0.067) without statistical significance. In the multivariate analysis, using the Cox regression, those with a non- adenocarcinoma showed a trend of high risk of cancer death than those with an adenocarcinoma without statistical significance (Relative risk; 2.754, 95% CI; 0.988∼7.672, p=0.053).
Conclusion: We could not find an independent prognostic factor of malignant pleural effusion in NSCLC. As there was a trend of high risk of cancer death according to histology, further study will be needed.
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KEYWORD
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Lung neoplasm, Effusion, Prognosis
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