Malignant Pleural Effusion Biomarkers as Predictor for Chemical Pleurodesis Success

Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis

“…Five studies including 709 participants presented the mean/median glucose level in patients with successful and failed pleurodesis [6,33,34,37,44]. The combined results showed higher glucose levels in favour of pleurodesis success with a mean glucose difference of 36.6 mg/dL (2 mmol/L ) (95 CI 16.3 -56.2 mg/dL) , p <0.001, I 2 93%, p<0.001 (figure 2A).…”

“…Heffner et al [6] presented LDH as a percentage of the upper limit of normal range and showed a significant difference in median percentages, with median LDH% of 85 for the successful group vs. 174 for the failure group (p 0.0005). Meta-analysis of the results from three studies [33,34,37] including 232 participants showed that lower LDH levels were associated with pleurodesis success with a mean difference between the success and failure groups of -728 IU/L (95% CI -1498 -43, p=0.064), I 2 95.5%, p<0.001 (figure 2B). Heffner et al [6] found that a cut-off for LDH% >146 had an AUC of 0.63 (95% CI 0.54-0.71), while Pantazouplos et al [33] found that a cut-off of >300 IU/L had an AUC of 0.61 to predict pleurodesis failure.…”

“…The results from six studies [6,26,33,34,37,45] including 866 participatns were combined in meta-analysis (figure 2C) which showed that higher pH was associated with pleurodesis success with a mean difference in pleural fluid pH between the success and failure groups of 0.124 (95% CI 0.107 -0.140, p=0.008), I 2 0%, p=0.473. Arellano-Orden et al [40] reported that successful pleurodesis correlated with pleural fluid pH with a correlation co-efficient (r) of 0.42.…”