비소세포폐암의 예후 결정에 있어 악성 흉수의 새로운 의의

New Prognostic Significance of Malignant Pleural Effusion In Patients with Non-Small Cell Lung Cancer

  • 김소영 (원광대학교 의과대학 내과) ;
  • 박성훈 (원광대학교 의과대학 영상의학과) ;
  • 신정현 (원광대학교 의과대학 내과) ;
  • 신성남 (원광대학교 의과대학 내과) ;
  • 김동 (원광대학교 의과대학 내과) ;
  • 이미경 (원광대학교 의과대학 흉부외과) ;
  • 이삼윤 (원광대학교 의과대학 흉부외과) ;
  • 최순호 (원광대학교 의과대학 흉부외과) ;
  • 김학렬 (원광대학교 의과대학 내과) ;
  • 정은택 (원광대학교 의과대학 내과) ;
  • 문성록 (원광대학교 의과대학 방사선종양학과) ;
  • 이강규 (원광대학교 의과대학 방사선종양학과) ;
  • 양세훈 (원광대학교 의과대학 내과)
  • Kim, So-Young (Department of Internal Medicine, Wonkwang University) ;
  • Park, Seong-Hoon (Department of Radiology, Wonkwang University) ;
  • Shin, Jeong-Hyun (Department of Internal Medicine, Wonkwang University) ;
  • Shin, Seong-Nam (Department of Internal Medicine, Wonkwang University) ;
  • Kim, Dong (Department of Internal Medicine, Wonkwang University) ;
  • Lee, Mi-Kung (Department of Thoracic Surgery, Wonkwang University) ;
  • Lee, Sam-Youn (Department of Thoracic Surgery, Wonkwang University) ;
  • Choi, Soon-Ho (Department of Thoracic Surgery, Wonkwang University) ;
  • Kim, Hak-Ryul (Department of Internal Medicine, Wonkwang University) ;
  • Jeong, Eun-Taik (Department of Internal Medicine, Wonkwang University) ;
  • Moon, Sun-Rock (Department of Radiation Oncology, Wonkwang University) ;
  • Lee, Kang-Kyu (Department of Radiation Oncology, Wonkwang University) ;
  • Yang, Sei-Hoon (Department of Internal Medicine, Wonkwang University)
  • 발행 : 2009.06.25

초록

Several studies showed that the survival rate of stage IIIB disease with malignant pleural effusion is worse than stage IIIB disease without malignant effusion. But, malignant pleural effusion was considered T4. To analyze changes the survival time for malignant pleural effusion, in the seventh revision of TNM classification for lung cancer. The records of all patients had to have either a histological or cytological diagnosis of non-small cell lung cancer (NSCLC), who were admitted to Wonkwang university hospital between January 2004 and December 2006 were reviewed retrospectively. We evaluated the survival time of 187 patients with advanced lung cancer with and without malignant pleural effusion. This included the pleural effusion or nodule M1 a (pleural dissemination, currently classified as T4), nodule(s) in the other lung M1 a (contralateral lung nodule, currently classified as M1), nodule(s) with the same lobe as the primary tumor T3 (currently classified as T4), other T4 factors T4 (T4 MO anyN), and extrathoracic sites of disease M1b (distant metastasis, currently classified M1). Among the 187 patients, T4anyNMO was 57 patients in the current TNM classification. In the next edition of the TNM classification, T4MOanyN-T4 (excluding same lobe nodules) was 12 patients, pleural dissemiantion-M1a was 45 patients, contralateral lung nodule(s)-M1a was 7 patients, and metastatic disease-M1b was 55 patients. We compared the survival time for these groups. Survival time was 11 months, 8 months, 11 months, and 4 months. The survival time of malignant pleural effusion was shorter than other T4 factors without pleural effusion. But, there was no remarkable difference in statistics due to small cases (p=0.23). We strongly suggest that malignant pleural effusion in advanced NSCLC will be categorized with metastatic disease.

키워드

참고문헌

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