HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Ken Kodama Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Higashiyama, M. Articles by Yokouchi, H. Search for Related Content PubMed PubMed Citation Articles by Higashiyama, M. Articles by Yokouchi, H. Related Collections Lung - cancer

J Thorac Cardiovasc Surg 2003;125:101-107
© 2003 The American Association for Thoracic Surgery

General Thoracic Surgery (GTS)

Intraoperative lavage cytologic analysis of surgical margins in patients undergoing limited surgery for lung cancer

From the Departments of Thoracic Surgery^a and Respiratory Medicine,^b Osaka Medical Center for Cancer and Cardiovascular Diseases, and the Department of Surgery,^c Suita Municipal Hospital, Osaka, Japan.

Supported in part by Grant-in-Aid for Cancer Research 13-9 from the Ministry of Health, Labor, and Welfare of Japan.

Received for publication Dec 18, 2001. Revisions requested March 8, 2002; revisions received July 2, 2002. Accepted for publication July 15, 2002. Address for reprints: Masahiko Higashiyama, MD, Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Nakamichi 1-3-3, Higashinari-ku, Osaka, 537-8511, Japan (E-mail: higasiyama-ma{at}mc.pref.osaka.jp).

Background: One of the unfavorable recurrent patterns after limited surgery for lung cancer is local failure, especially at the surgical margin in the pulmonary parenchyma. To prevent this failure, we preliminarily introduced a novel intraoperative lavage cytologic technique to check surgical margin status for limited surgery. In this study we analyzed the clinical utility of this technique with a larger number of patients under long-term follow-up.
Methods: A total 112 consecutive lung cancer lesions prospectively treated by limited surgery with the intraoperative lavage cytologic technique between October 1997 and August 2000 were reviewed through a median follow-up period of 27 months.
Results: Eleven lesions (10%) showed cytologically positive results in the attempted surgery on the surgical margin. The positive result rate was significantly higher for lesions with more advanced stage, compromised indication, incurability, and larger size. Surgical modes were converted intraoperatively for 4 lesions; in the other 7 lesions no conversion was performed because of certain disadvantages. Local recurrence in the surgical margin occurred in a total of 4 lesions, including 3 for which the operative mode was unconverted and 1 lesion with cytologically unknown status of the surgical margin that had the mode converted, whereas there were no local recurrences in the surgical margins among the lesions with final cytologically negative results.
Conclusion: Cytologically negative results of examination of the surgical margin by the technique of intraoperative lavage cytologic in limited surgery for lung cancer may be predict lack of local recurrence in the surgical margin. This intraoperative cytologic technique is clinically useful in checking for complete resection of this primary disease.

This article has been cited by other articles:

				N. Sawabata, Y. Karube, H. Umezu, M. Tamura, N. Seki, H. Ishihama, K. Honma, and S. Miyoshi Cytologically malignant margin without continuous pulmonary tumor lesion: cases of wedge resection, segmentectomy and lobectomy Interactive CardioVascular and Thoracic Surgery, December 1, 2008; 7(6): 1044 - 1048. [Abstract] [Full Text] [PDF]

				K. Kodama, M. Higashiyama, K. Takami, K. Oda, J. Okami, J. Maeda, M. Koyama, and T. Nakayama Treatment strategy for patients with small peripheral lung lesion(s): intermediate-term results of prospective study Eur. J. Cardiothorac. Surg., November 1, 2008; 34(5): 1068 - 1074. [Abstract] [Full Text] [PDF]

				M. J. Schuchert, B. L. Pettiford, S. Keeley, T. A. D'Amato, A. Kilic, J. Close, A. Pennathur, R. Santos, H. C. Fernando, J. R. Landreneau, et al. Anatomic Segmentectomy in the Treatment of Stage I Non-Small Cell Lung Cancer Ann. Thorac. Surg., September 1, 2007; 84(3): 926 - 933. [Abstract] [Full Text] [PDF]

				H. Nomori, K. Ikeda, T. Mori, H. Kobayashi, K. Iwatani, K. Kawanaka, S. Shiraishi, and T. Kobayashi Reply to the Editor J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 822 - 823. [Full Text] [PDF]

				A. El-Sherif, H. C. Fernando, R. Santos, B. Pettiford, J. D. Luketich, J. M. Close, and R. J. Landreneau Margin and Local Recurrence After Sublobar Resection of Non-Small Cell Lung Cancer Ann. Surg. Oncol., August 1, 2007; 14(8): 2400 - 2405. [Abstract] [Full Text] [PDF]

				M. Okada, T. Koike, M. Higashiyama, Y. Yamato, K. Kodama, and N. Tsubota Radical sublobar resection for small-sized non small cell lung cancer: A multicenter study J. Thorac. Cardiovasc. Surg., October 1, 2006; 132(4): 769 - 775. [Abstract] [Full Text] [PDF]

				T. Fukuse, E. Ogawa, F. Chen, H. Sakai, and H. Wada Limited surgery and radiofrequency ablation for recurrent lung cancer. Ann. Thorac. Surg., October 1, 2006; 82(4): 1506 - 1508. [Abstract] [Full Text] [PDF]

				S. Shiono, G. Ishii, K. Nagai, J. Yoshida, M. Nishimura, Y. Murata, K. Tsuta, Y. H. Kim, Y. Nishiwaki, T. Kodama, et al. Predictive Factors for Local Recurrence of Resected Colorectal Lung Metastases Ann. Thorac. Surg., September 1, 2005; 80(3): 1040 - 1045. [Abstract] [Full Text] [PDF]

				B. D. T. Daly and T. A. DiPetrillo Limited resection of non-small cell lung cancer: should brachytherapy be indicated in all cases?: Reply Ann. Thorac. Surg., April 1, 2004; 77(4): 1504 - 1504. [Full Text] [PDF]

				N. Sawabata, M. Inoue, S.-i. Takeda, and H. Maeda Limited resection of non-small cell lung cancer: should brachytherapy be indicated in all cases? Ann. Thorac. Surg., April 1, 2004; 77(4): 1503 - 1504. [Full Text] [PDF]

				N. Sawabata, M. Ohta, A. Matsumura, K. Nakagawa, H. Hirano, H. Maeda, and H. Matsuda Optimal distance of malignant negative margin in excision of nonsmall cell lung cancer: a multicenter prospective study Ann. Thorac. Surg., February 1, 2004; 77(2): 415 - 420. [Abstract] [Full Text] [PDF]

				M. Higashiyama, K. Kodama, K. Takami, N. Higaki, T. Nakayama, and H. Yokouchi Malignant status at surgical margin of limited-resected non-small cell lung cancer: a crucial finding for predicting local relapse: Reply to the Editor J. Thorac. Cardiovasc. Surg., August 1, 2003; 126(2): 611 - 611. [Full Text] [PDF]

				N. Sawabata Malignant status at surgical margin of limited-resected non-small cell lung cancer: a crucial finding for predicting local relapse J. Thorac. Cardiovasc. Surg., August 1, 2003; 126(2): 610 - 611. [Full Text] [PDF]