The influence of enhanced postoperative inflammation by the intrapleural administration of streptococcal preparation (OK-432) on the prognosis of completely resected non-small-cell lung cancer

Background and Objectives: It is not clear whether postoperative inflammati on affects the prognosis of malignant disease. Methods: We retrospectively reviewed the patients with non-small-cell lung cancer who underwent a complete resection at the National Kyushu Cancer Cen ter from 1989 to 1996. For the treatment of prolonged air leakage after a p ulmonary lobectomy, 25 patients received an intrapleural injection of OK-43 2, a lyophilized preparation of the heat- and penicillin-treated Su-strain of the Streptococcus pyogenes group A3. All patients were males who were ol der than 50 years of age. As a control, we selected 164 male patients who w ere older than 50 years of age and not given OK-432 during the same period. Results: The administration of OK-432 in most patients was performed on the 4th day after the operation. Pleural drainage could be terminated in a mea n of 5.5 days after the intrapleural administration of OK-432. In the contr ol group, the serum C-reactive protein (CRP) level reached a peak on day 4 after the operation and returned to almost a normal level on day 14 after t he operation. In the OK-432 group, the peak CRP level, which was significan tly higher than that in the control group, was observed on day 7 after the operation and the elevated CRP level was maintained until 28 days after the operation. The mean level of CRP in the OK-432 group was significantly hig her than that in the control on days 7, 14, and 28 after the operation. No significant difference was observed in the disease-free survivals between t he 2 groups. Conclusions: Based on the above findings, postoperative prolonged inflammat ion does not seem to affect the progression of subclinically residual tumor cells. J. Surg. Oncol. 2000;75:51-54. (C) 2000 Wiley-Liss, Inc.