The prognostic significance of minor pleural effusions in patients with potentially operable bronchogenic carcinoma

Pleural effusion complicating lung cancer is generally considered as a sign of unresectability. This study was undertaken in order to clarify the prognostic significance of minor pleural effusion complicating lung cancer. Twenty patients, who fulfilled the following requirements, were considered: 1) potentially operable bronchogenic carcinoma, which had not received previous therapy, 2) undiagnosed or only suspected pleural effusion on standard x-ray examination, 3) evidence of minor pleural effusion at CT scan investigation, 4) no pleural fluid drawn at thoracocentesis, and 5) thoracotomy, entailing collection of pleural fluid (100 ml) for cytology. Minor pleural effusions proved non-bloody and cytologically negative in 19 out of the 20 patients. However, they were associated with poor resectability rate (50%). Median survival was 14 months for the whole group of patients, and more than 37 months for the completely resected subgroup. Survival rates were not significantly different from those found in a similar group of patients with bronchogenic carcinoma but without any pleural effusion. Although minor pleural effusions complicating lung cancer do not preclude either curative resection or long-term survival expectancy, they usually indicate advanced disease.