[Thoracocentesis for the assessment of XXXX with @entity1143 ].

@entity1143 @entity1 @entity66 @entity5 @entity2617 @entity2 @entity2286 @entity764 @entity3
OBJECTIVE: To analyze the pleural and mediastinal effect of thoracentesis @entity5 -positive cytology in @entity1143 ( @entity1143 ) detected by @entity764 ray of @entity2 @entity1 . @entity1 AND METHODS: The study was performed in @entity1 with @entity2 for whom @entity1143 was evident in @entity764 ray films, who then underwent thoracentesis followed by video-assisted thoracoscopy (VAT) to evaluate direct @entity5 infiltration, mediastinal node involvement and the existence of @entity3 . @entity1 without contraindication underwent the procedure, even if @entity5 positive cytology was present. When @entity3 was found the treatment employed was talc pleurodesis and chemotherapy. Descriptive statistics were compiled and the validity of VAT for @entity3 diagnosis, of thoracentesis pleural cytology to detect infiltration of the @entity5 -adyacent pleura, @entity66 and @entity3 were calculated. Survival was also analyzed. RESULTS: @entity1143 was present in 188 of 971 consecutive @entity2 @entity1 . Seventy two PEs were visible in the @entity764 ray films. Volume exceeded 425 mL. Tumor positive pleural cytology was detected in 29 cases (40%). Pleural @entity3 were found in 54 @entity1 , 23 of whom had @entity5 positive pleural cytology. In the other 6 @entity1 with positive cytology the @entity5 infiltrated the visceral pleura, completely in 5. In 4 of those 5, the mediastinal pleura was also involved. The @entity5 and diseased lymph nodes were removed from 11 @entity1 , 3 of them with tumoral pleural cytology. Visual pleural inspection by VAT had a sensitivity of 93%, specificity of 82%, positive predicted value ( @entity2286 ) of 94% and negative predicted value (NPV) of 78% for the diagnosis of @entity3 . Thoracentesis cytology showed a sensitivity of 43%, specificity of 67%, @entity2286 of 79% and NPV of 28% for @entity3 . For the evaluation of adjacent @entity2617 , without @entity3 , the sensitivity of cytology was 40%, specificity 100%, @entity2286 100% and NPV 25%. For mediastinal node invasion clinically evaluated, the sensitivity of cytology was 55%, specificity of 62%, @entity2286 18% and NPV 90%. Survival after thoracotomy was 39% after 2 years, and the median survival time was 14.5 months. In the 11 resected @entity1 , survival was 53% at two years. The difference in survival between @entity1 treated by thoracotomy and those treated by talc pleurodesis after VAT was significant (p < 0.01). The 3 resected @entity1 with @entity5 -positive cytology survived 84, 39 and 25 months. CONCLUSIONS: Nineteen percent of @entity1 with @entity2 have @entity1143 , of which 7% can be seen in @entity764 ray films. In such @entity1 the likelihood of @entity3 is 75%. Pleural @entity3 is not necessarily present when @entity1143 cytology indicates that @entity5 is present. VAT can be considered the ideal technique for the assessment of direct pleural invasion by the @entity5 or of @entity3 .
