INTRAPULMONIC TUMOR-CELL DISSEMINATION AN D INTRAOPERATIVE PLEURAL LAVAGE AS PROGNOSTIC FACTORS IN LUNG-CANCER

Tumor cell detection in lavage fluids might be a prognostic factor in solid tumors. Therefore, 342 patients with the first manifestation of lung cancer underwent intraoperative pleural lavage (lavage I = after opening the chest; lavage II = after resection of lung cancer). Tumor cells were found in lavage I in 132 patients (38.6%), in 99 of them al so in lavage II. We found tumor cells in only nine cases in lavage II cytologically. The cumulative 5 year survival rate of non-small cell l ung cancer in stage I (n = 164) was 25.9% if lavage was positive (lava ges I and II, n = 47), and 69.2% if lavage was negative (n = 117) (p<0 .05). Additionally, we performed tissue cultures of tumor-free parench yma in 23 cases of lung cancer. In 16 cases (69.6%), we detected tumor cells by histology and immunohistology. Cytologic tumor cell detectio n in intraoperative pleural lavage in lung cancer seems to be an addit ional prognostic factor and should be done when assessing the final tu mor stage. A positive result should be added to the pTNM classificatio n.