The prognostic analysis of non-small cell lung cancer with unexpected pleural cavity dissemination

Background: The prognosis of advanced non-small cell lung cancer (NSCLC) is poor. At present, incidental pleural cavity dissemination during operation is still unavoidable. The clinicopathological features and the best way to deal with incidental pleural cavity dissemination during operation has not been determined. Methods: : 58 NSCLC patients with pleural cavity disseminated incidentally found during surgery were included in our retrospective research from December 2012 to August 2018 according to the 8th edition of TNM staging. None of these had distant metastasis. Results: : Univariate and multivariate analysis revealed that targeted therapy was the only predictor of prognosis. Among patients receiving lymph node sampling or dissection, univariate analysis revealed that more advanced stage, lymph node metastasis, and higher proportion of metastatic lymph nodes were associated with worse progression-free survival (PFS). Smoking, more advanced stage, higher proportion of metastatic lymph nodes and no targeted therapy were significantly associated with worse overall survival (OS). Multivariate analysis recognized targeted therapy as the only predictor of prognosis. In patients not receiving targeted therapy, pleural cavity infusion chemotherapy seemed to be beneficial both to PFS and OS, but without statistical significance. Multivariate analysis found that lymph node metastasis was the only predictor of PFS, but no predictor of OS. Conclusions: : Targeted therapy is the best treatment for NSCLC patients with incidentally pleural cavity dissemination if there was target gene mutation. Pleural cavity infusion chemotherapy has potential survival benefit for patients without target gene mutations. Lymph node metastasis is not beneficial to the prognosis of patients with pleural cavity dissemination.