Visceral pleural infiltration as a negative prognostic factor in lung metastasis

The prognostic value of visceral pleural infiltration in lung metastasis was analysed. Fifty-two patients (32 males and 20 females) were operated on for lung metastases. The locations of the primary tumours were as follows: 19 colon, 10 kidneys, 8 melanomas, 3 breast, 3 bladder, 2 uterus, 2 osteosarcomas, 1 testis, and 1 parotid, 1 haemangiopericytoma, 1 thyroid gland and 1 larynx. Explorative thoracotomies and incomplete resections were excluded from the study. Visceral pleural infiltration was present in 20 of the 52 cases. There was a significant correlation between the occurrence of pleural infiltration and multiple lesions (P=0.019). The overall five-year survival rate was 33.6%. In a subgroup of 38 patients with N0 and single metastases, the five-year survival rate was 73% and 12% in the cases without and with visceral pleural infiltration, respectively (P=0.003). Multivariate analysis of pleural infiltration, lymph node metastasis, multiple lesions and DFI revealed that only pleural infiltration (P=0.003) had a significant impact on survival. In one-third of the pulmonary metastases, visceral pleural infiltration appeared. There was a significant correlation between the occurrence of visceral pleural infiltration and multiple lesions. Visceral pleural infiltration in lung metastasis is a negative prognostic factor, and in these cases, survival was significantly reduced.