Malignant minor pleural effusion detected on thoracotomy for patients with non-small cell lung cancer: Is tumor resection beneficial for prognosis?

Background. This study attempts to clarify the benefit of surgery for non-small cell lung cancer (NSCLC) with malignant minor pleural effusion that is detected at thoracotomy. Methods. Records of surgical patients with NSCLC were reviewed, with a definition of minor pleural effusion as less than 300 mL. The patients were divided into three groups as follows: (1) group C consisted of patients who underwent grossly complete resection; group 1, patients with incomplete tumor resection; and group E, patients who underwent exploratory thoracotomy only. Results. There were 196 patients who had minor pleural effusion; of these, 96 (46%) underwent an examination to define the malignancy status of pleural effusion after surgery. In 43 patients (45%), the effusion was found to be malignant. The median survival time and 5-year survival rate, respectively, were 13 months and 9% for group C (n = 11); 34 months and 10% for group I (n = 14; P = 0.3); and 17 months and 0% for group E (n = 18; p = 0.8). Conclusions. Tumor resection is not beneficial for the survival of patients with NSCLC who have a minor malignant pleural effusion. (C) 2002 by The Society of Thoracic Surgeons.