Life expectancy of patients with malignant pleural effusion treated with video-assisted thoracoscopic talc pleurodesis

Abstract

The aim of the current study was to analyse postoperative complications and survival after video-assisted thoracoscopic (VATS) talc pleurodesis for malignant pleural effusion. All patients with morphologically proven malignant pleural effusion who underwent VATS talc pleurodesis from November 1995 to November 2002 were included in retrospective analysis. VATS was performed in general anaesthesia and 5 g of asbestos-free talc was insufflated into the pleural cavity. Postoperative pleural drainage was used until fluid output was less than 100 ml/24 h. Ninety-eight patients (28 male and 70 female) with mean age 59.6 (range 18-82) years were included. Thirteen patients had a bilateral pleural effusion. The most common primary cancer sites were lung (30 cases), breast (25) and ovarium (11). Average duration of the operation was 46 (range 10-120) min. Median duration of postoperative drainage was 3 (range 1-20) days and postoperative hospitalisation 7 (range 3-70) days. Twenty-eight patients had postoperative complications (fever in 17 cases). In seven cases pleurodesis was ineffective. Median survival was 8.4 months. Six-, 12- and 24-month survival was 58% (95% CI [0.47-0.67]), 39% [0.29-0.49] and 20% [0.12-0.29], respectively. Survival data after VATS talc pleurodesis advocate use of this invasive treatment method despite the advanced stage of cancer.

Intrapleural hyperthermic perfusion chemotherapy in subjects with metastatic pleural malignancies

“…Currently, palliative therapy either with pleurodesis or pleurectomy/ decortication is the choice of treatment in secondary MPEs. 17 Other treatment approaches are chemotherapy and/or radiotherapy. Unfortunately, none of these approaches provides a significant benefit for the survival.…”

Video-assisted thoracoscopic diagnosis of trapped lung in malignant pleural effusions

“…Malignant pleural effusions are a sign of advanced stage of the disease with poor prognosis for the patients and life expectancy of 6 to 9 months (1,12,13). With regard to the treatment plan, the main goal is achieving effective palliation of the clinical manifestationsreduction of dyspnea, pain relief, discomfort, better quality of life.…”

Pleurodesis with pseudomonas aeruginosa-mannose–sensitive hemagglutinin for pneumothorax secondary to COPD: a retrospective study

“…Common side effects of talc include fever (10-17%), pain, and gastrointestinal symptoms. Less common side effects include arrhythmia, dyspnea, respiratory failure, a systemic inflammatory response, empyema, and the dissemination of talc to other regions [8][9][10]. However, talc particles and other pro-fibrotic factors hypothetically have the potential to be absorbed and lead to systemic inflammation.…”