The influence of enhanced postoperative inflammation by the intrapleural administration of streptococcal preparation (OK-432) on the prognosis of completely resected non-small-cell lung cancer

Background and Objectives It is not clear whether postoperative inflammation affects the prognosis of malignant disease. Methods We retrospectively reviewed the patients with non‐small‐cell lung cancer who underwent a complete resection at the National Kyushu Cancer Center from 1989 to 1996. For the treatment of prolonged air leakage after a pulmonary lobectomy, 25 patients received an intrapleural injection of OK‐432, a lyophilized preparation of the heat‐ and penicillin‐treated Su‐strain of the Streptococcus pyogenes group A3. All patients were males who were older than 50 years of age. As a control, we selected 164 male patients who were older than 50 years of age and not given OK‐432 during the same period. Results The administration of OK‐432 in most patients was performed on the 4th day after the operation. Pleural drainage could be terminated in a mean of 5.5 days after the intrapleural administration of OK‐432. In the control group, the serum C‐reactive protein (CRP) level reached a peak on day 4 after the operation and returned to almost a normal level on day 14 after the operation. In the OK‐432 group, the peak CRP level, which was significantly higher than that in the control group, was observed on day 7 after the operation and the elevated CRP level was maintained until 28 days after the operation. The mean level of CRP in the OK‐432 group was significantly higher than that in the control on days 7, 14, and 28 after the operation. No significant difference was observed in the disease‐free survivals between the two groups. Conclusions Based on the above findings, postoperative prolonged inflammation does not seem to affect the progression of subclinically residual tumor cells. J. Surg. Oncol. 2000;75:51–54. © 2000 Wiley‐Liss, Inc.