PROGNOSTIC VALUE OF PLEURAL EFFUSION IN PATIENTS WITH NONSMALL CELL LUNG-CANCER

This study was performed to determine whether pleural effusion in pati ents with advanced non-small cell lung cancer (NSCLC) has a negative i mpact on survival, We evaluated 12 prognostic factors in 197 patients with stage IIIB or TV NSCLC, Each factor was dichotomized, and surviva l curves calculated by the Kaplan-Meier technique were compared using the log-rank test, The Cox proportional hazards regression model was u sed to confirm the significance of each prognostic factor selected by univariate analysis, We compared the survival times for stage IIIB wit h pleural effusion with those of stage IIIB without effusion and stage IV, To determine the impact of the cytological results of the effusio n on survival, we compared the survival times for cytologically positi ve and negative effusions, Univariate analysis identified eight signif icant prognostic factors: pleural effusion, node status, stage, perfor mance status, weight loss, hemoglobin, albumin, and lactate dehydrogen ase, Pleural effusion was selected as a prognostic factor in the multi variate analysis, together with stage, performance status, albumin, an d node status, Median survival times for stage IIIB without effusion, stage IIIB with effusion, and stage IV were 15.3, 7.5, and 5.5 months, respectively (P < 0.0001), Survival time for stage IIIB with effusion was significantly different from that of stage IIIB without effusion (P = 0.0129) but not from that of stage ni (P = 0.0797), Among patient s with effusion, no significant difference in survival time was observ ed between cytologically positive and negative effusions, We conclude that pleural effusion in advanced NSCLC is a prognostic factor, Surviv al time for stage IIIB with pleural effusion is more similar to that o f stage IV rather than that of stage IIIB without effusion.