{"title":"OK-432胸膜切除术对肺癌患者肺叶切除术后长期生存结局的影响：一项回顾性病例对照研究","authors":"Hisashi Oishi, Ken Onodera, Hirotsugu Notsuda, Tatsuaki Watanabe, Yui Watanabe, Takaya Suzuki, Takeo Togo, Sakiko Kumata, Yoshinori Okada","doi":"10.21037/jtd-2024-2253","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>OK-432 (Picibanil), derived from <i>Streptococcus pyogenes</i> type A3, is widely used for both cancer immunotherapy and pleurodesis to manage pleural effusions and air leaks. While its efficacy and safety in pleurodesis are well-established, its potential immunomodulatory effects on long-term survival outcomes in lung cancer patients remain unclear. This study aims to evaluate whether OK-432 pleurodesis influences postoperative survival and recurrence outcomes following pulmonary lobectomy for non-small cell lung cancer.</p><p><strong>Methods: </strong>This retrospective study analyzed data from 413 patients who underwent pulmonary lobectomy for non-small cell lung cancer between January 2010 and December 2016. Patients were categorized into two groups: those who underwent OK-432 pleurodesis for prolonged air leaks or chylothorax (n=23) and a control group receiving other treatments or none (n=390). We examined demographics, surgical outcomes, and postoperative complications, assessing survival and recurrence using the Kaplan-Meier method and Cox proportional hazards models.</p><p><strong>Results: </strong>The administration of OK-432 effectively managed air leaks and chylothorax without significant complications. There were no statistically significant differences in overall survival (OS), lung cancer-specific survival (LCSS), or recurrence-free survival (RFS) between the groups. Advanced pathological stages were significant predictors of mortality and recurrence.</p><p><strong>Conclusions: </strong>While OK-432 pleurodesis is effective for the management of air leaks and chylothorax following pulmonary lobectomy, this study did not demonstrate any impact on OS, LCSS, or RFS. These findings confirm the utility of OK-432 in addressing immediate postoperative challenges but do not support its use as a prognostic factor in the long-term management of lung cancer. Further investigation is necessary to explore the full spectrum of OK-432's biological effects and potential benefits in a broader oncological context.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2067-2077"},"PeriodicalIF":2.1000,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090127/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of OK-432 pleurodesis on long-term survival outcomes after pulmonary lobectomy for lung cancer patients: a retrospective case-control study.\",\"authors\":\"Hisashi Oishi, Ken Onodera, Hirotsugu Notsuda, Tatsuaki Watanabe, Yui Watanabe, Takaya Suzuki, Takeo Togo, Sakiko Kumata, Yoshinori Okada\",\"doi\":\"10.21037/jtd-2024-2253\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>OK-432 (Picibanil), derived from <i>Streptococcus pyogenes</i> type A3, is widely used for both cancer immunotherapy and pleurodesis to manage pleural effusions and air leaks. While its efficacy and safety in pleurodesis are well-established, its potential immunomodulatory effects on long-term survival outcomes in lung cancer patients remain unclear. This study aims to evaluate whether OK-432 pleurodesis influences postoperative survival and recurrence outcomes following pulmonary lobectomy for non-small cell lung cancer.</p><p><strong>Methods: </strong>This retrospective study analyzed data from 413 patients who underwent pulmonary lobectomy for non-small cell lung cancer between January 2010 and December 2016. Patients were categorized into two groups: those who underwent OK-432 pleurodesis for prolonged air leaks or chylothorax (n=23) and a control group receiving other treatments or none (n=390). We examined demographics, surgical outcomes, and postoperative complications, assessing survival and recurrence using the Kaplan-Meier method and Cox proportional hazards models.</p><p><strong>Results: </strong>The administration of OK-432 effectively managed air leaks and chylothorax without significant complications. There were no statistically significant differences in overall survival (OS), lung cancer-specific survival (LCSS), or recurrence-free survival (RFS) between the groups. Advanced pathological stages were significant predictors of mortality and recurrence.</p><p><strong>Conclusions: </strong>While OK-432 pleurodesis is effective for the management of air leaks and chylothorax following pulmonary lobectomy, this study did not demonstrate any impact on OS, LCSS, or RFS. These findings confirm the utility of OK-432 in addressing immediate postoperative challenges but do not support its use as a prognostic factor in the long-term management of lung cancer. Further investigation is necessary to explore the full spectrum of OK-432's biological effects and potential benefits in a broader oncological context.</p>\",\"PeriodicalId\":17542,\"journal\":{\"name\":\"Journal of thoracic disease\",\"volume\":\"17 4\",\"pages\":\"2067-2077\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-04-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090127/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of thoracic disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/jtd-2024-2253\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-2024-2253","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/21 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Effect of OK-432 pleurodesis on long-term survival outcomes after pulmonary lobectomy for lung cancer patients: a retrospective case-control study.
Background: OK-432 (Picibanil), derived from Streptococcus pyogenes type A3, is widely used for both cancer immunotherapy and pleurodesis to manage pleural effusions and air leaks. While its efficacy and safety in pleurodesis are well-established, its potential immunomodulatory effects on long-term survival outcomes in lung cancer patients remain unclear. This study aims to evaluate whether OK-432 pleurodesis influences postoperative survival and recurrence outcomes following pulmonary lobectomy for non-small cell lung cancer.
Methods: This retrospective study analyzed data from 413 patients who underwent pulmonary lobectomy for non-small cell lung cancer between January 2010 and December 2016. Patients were categorized into two groups: those who underwent OK-432 pleurodesis for prolonged air leaks or chylothorax (n=23) and a control group receiving other treatments or none (n=390). We examined demographics, surgical outcomes, and postoperative complications, assessing survival and recurrence using the Kaplan-Meier method and Cox proportional hazards models.
Results: The administration of OK-432 effectively managed air leaks and chylothorax without significant complications. There were no statistically significant differences in overall survival (OS), lung cancer-specific survival (LCSS), or recurrence-free survival (RFS) between the groups. Advanced pathological stages were significant predictors of mortality and recurrence.
Conclusions: While OK-432 pleurodesis is effective for the management of air leaks and chylothorax following pulmonary lobectomy, this study did not demonstrate any impact on OS, LCSS, or RFS. These findings confirm the utility of OK-432 in addressing immediate postoperative challenges but do not support its use as a prognostic factor in the long-term management of lung cancer. Further investigation is necessary to explore the full spectrum of OK-432's biological effects and potential benefits in a broader oncological context.
期刊介绍：
The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.
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