LONG-TERM RESULTS OF POSTOPERATIVE INTRATHORACIC CHEMO-THERMOTHERAPY FOR LUNG-CANCER WITH PLEURAL DISSEMINATION

Background. To overcome the poor prognosis of lung cancer with pleural dissemination, the authors developed postoperative intrathoracic chem o-thermotherapy (PICT). In this report, they present the long-term res ults for 31 consecutive patients who underwent resection, followed by PICT for lung cancer with pleural dissemination between April 1985 and December 1991. Methods. Among the patients, there were 26 cases of ad enocarcinoma, 3 cases of squamous cell carcinoma, and 1 case each of l arge and adenosquamous cell carcinoma. Twenty-four of these patients h ad an initial diagnosis of pleural involvement at thoracotomy. The oth er seven patients had massive malignant effusion at the time of the in itial diagnosis. PICT was started between days 10 to 14 postoperativel y. When possible, three courses of this procedure were administered at intervals of 5-7 days. Results. The 5-year cumulative and 5-year loca l relapse-free survival rates were 24.6% and 76.3%, respectively. The 3-year and 5-year cumulative survival rates for 14 patients without me diastinal lymph node involvement were 68.4% and 42.7%, respectively. T hose rates for 17 patients with mediastinal lymph node involvement wer e 22.7% and 0%, respectively. The 3-year survival rate in the former g roup was significantly better than that in the latter group. Conclusio ns. These results strongly suggest that in patients with pleural disse mination, PICT may be beneficial for regional disease control and impr ovement of survival, particularly for patients without mediastinal lym ph node involvement.