Malignant effusions correlate with poorer prognosis in XXXX with @entity1892 .

@entity1 @entity1143 @entity5 @entity1892 @entity30807
OBJECTIVES: Serous effusions are a common manifestation of @entity1892 ( @entity1892 ). However, their prognostic significance is controversial. METHODS: We searched for consecutive @entity1 who had @entity1892 with effusions from 1999 through 2007. Primary @entity30807 was excluded. The presence of @entity5 cells in effusions (malignant effusions) was determined by cytology supplemented by flow cytometry, cell blocks with special studies, polymerase chain reaction for clonality, or conventional cytogenetics. RESULTS: Forty-one (18.4%) @entity1 had effusions, with 24 (58.5%) developing at diagnosis and 17 (41.5%) during @entity5 course. Nineteen @entity1 (46.0%) had malignant effusions, with six (31.6%) from local extension and 13 (68.4%) through wide dissemination. Interestingly, malignant effusion correlated with a high International Prognostic Index (IPI) score (r = 0.490, P = .002) and high @entity5 stage (r = 0.342, P = .031) and was a poor prognosticator (P < .001, log-rank test), even worse than stage IV disease (P = .036). In the multivariate analysis, malignant effusion (P = .056) and supportive care (P = .014) retained significance and were more powerful than IPI score and stage. CONCLUSIONS: @entity1 who have @entity1892 with @entity1143 have a poor prognosis and should be treated as having stage IV disease. The analysis of effusions for @entity5 cells would be a useful addition to the routine workup.
