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A retrospective chart study revealed improved survival rates in patients in whom empyema developed after surgical resection for carcinoma of the lung. The overall five-year survival rate for the empyema group of 18 patients was 50 per cent, compared to an 18 per cent five-year survival rate in a control group consisting of a random 34-patient sample of resected cases at this institution. On further analysis, the beneficial effect of intrapleural infection was found principally in patients with tumor limited to the lung and its draining regional lymph nodes. Six of seven patients in this group survived for five years. The protection from recurrent cancer conferred on these patients by postoperative empyema may have been mediated by the activation of regional cellular immune mechanisms. The reaction between immune lymphocytes and bacterial antigens is believed to release lymphokines and activate macrophages that nonspecifically destroy residual tumor cells while containing the intrapleural infection.
Ruckdeschel et al. (Thu,) studied this question.
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