Malignant pleural effusion management: keeping the flood gates shut

Walker, Steven; Mercer, Rachel; Maskell, Nick A; Rahman, Najib M.

doi:10.1016/s2213-2600(19)30373-x

Cited by 32 publications

(24 citation statements)

References 47 publications

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“…In contrast, mesothelioma, a primary pleural malignancy linked to asbestos exposure, is a relatively rare cause of MPE compared to metastases [ 3 , 4 , 6 ]. MPEs confer significant morbidity, mortality, and poor survival rates, while their management is primarily palliative, intending to ease symptoms and improve quality of life [ 3 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Molecular Profiling of Malignant Pleural Effusions with Next Generation Sequencing (NGS): Evidence that Supports Its Role in Cancer Management

Grigoriadou

Esagian

Ryu

et al. 2020

JPM

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Malignant pleural effusions (MPEs) often develop in advanced cancer patients and confer significant morbidity and mortality. In this review, we evaluated whether molecular profiling of MPEs with next generation sequencing (NGS) could have a role in cancer management, focusing on lung cancer. We reviewed and compared the diagnostic performance of pleural fluid liquid biopsy with other types of samples. When applied in MPEs, NGS may have comparable performance with corresponding tissue biopsies, yield higher DNA amount, and detect more genetic aberrations than blood-derived liquid biopsies. NGS in MPEs may also be preferable to plasma liquid biopsy in advanced cancer patients with a MPE and a paucicellular or it could be difficult to obtain tissue/fine-needle aspiration biopsy. Of interest, post-centrifuge supernatant NGS may exhibit superior results compared to cell pellet, cell block or other materials. NGS in MPEs can also guide clinicians in tailoring established therapies and identifying therapy resistance. Evidence is still premature regarding the role of NGS in MPEs from patients with cancers other than lung. We concluded that MPE processing could provide useful prognostic and theranostic information, besides its diagnostic role.

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Section: Introductionmentioning

confidence: 99%

Molecular Profiling of Malignant Pleural Effusions with Next Generation Sequencing (NGS): Evidence that Supports Its Role in Cancer Management

Grigoriadou

Esagian

Ryu

et al. 2020

JPM

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“…These measurements may not reflect the pressures of the pleural cavity, as they were only taken during brief interruptions in the drains. Determining the real pressures at the end of the expiration, which change several times during the respiratory cycle, is complex and may not be accurate [ 41 ].…”

Section: Diagnostic Testsmentioning

confidence: 99%

“… Recent trials addressing the management of malignant pleural effusion (modified under authorization) [ 41 ]. IPC, indwelling pleural catheter.…”

Section: Figurementioning

confidence: 99%

Malignant Pleural Effusion: Diagnosis and Management

Ferreiro

Suárez-Antelo

Álvarez-Dobaño

et al. 2020

Canadian Respiratory Journal

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Symptomatic malignant pleural effusion is a common clinical problem. This condition is associated with very high mortality, with life expectancy ranging from 3 to 12 months. Studies are contributing evidence on an increasing number of therapeutic options (therapeutic thoracentesis, thoracoscopic pleurodesis or thoracic drainage, indwelling pleural catheter, surgery, or a combination of these therapies). Despite the availability of therapies, the management of malignant pleural effusion is challenging and is mainly focused on the relief of symptoms. The therapy to be administered needs to be designed on a case-by-case basis considering patient’s preferences, life expectancy, tumour type, presence of a trapped lung, resources available, and experience of the treating team. At present, the management of malignant pleural effusion has evolved towards less invasive approaches based on ambulatory care. This approach spares the patient the discomfort caused by more invasive interventions and reduces the economic burden of the disease. A review was performed of the diagnosis and the different approaches to the management of malignant pleural effusion, with special emphasis on their indications, usefulness, cost-effectiveness, and complications. Further research is needed to shed light on the current matters of controversy and help establish a standardized, more effective management of this clinical problem.

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“…2 MPE is associated with signi cant symptom burden and often require more than one pleural intervention, consuming signi cant resources. 3 Pleural interventions can be regular therapeutic thoracenteses, intercostal drain insertion with talc pleurodesis, indwelling pleural catheter (IPC) insertion with or without talc instillation or medical (local anaesthetic) or video assisted thoracoscopy. 3 A patient-centred approach where patients can choose between the various modalities is advocated and patient education plays an important role in this approach.…”

Section: Introductionmentioning

confidence: 99%

“…3 Pleural interventions can be regular therapeutic thoracenteses, intercostal drain insertion with talc pleurodesis, indwelling pleural catheter (IPC) insertion with or without talc instillation or medical (local anaesthetic) or video assisted thoracoscopy. 3 A patient-centred approach where patients can choose between the various modalities is advocated and patient education plays an important role in this approach. 4 IPCs can be performed as a day case procedure and preferred by many clinicians.…”

Section: Introductionmentioning

confidence: 99%

Indwelling pleural catheters for malignancy related pleural effusions

Aujayeb

2020

Preprint

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ObjectivesThe incidence of malignancy related pleural effusions (MPE) is increasing. MPE carry significant morbidity and mortality. Indwelling pleural catheters (IPCs) have become the cornerstone in management and are supported by established international guidance. Large case reviews add to the evidence base regarding safety and efficacy. Methods168 patients had an IPC insertion between January 2012 and December 2018 in a large pleural centre in the North East of England. Data on outcomes and complications were obtained from the patients’ notes, electronic records, laboratory, and radiographic findings. Descriptive statistical methodology was applied. Results168 IPCs were inserted in a predominantly male population by experienced pleural practitioners. Overall complication rate is 13% and the incidence of any individual complications such as infection, metastatic seeding, drain displacement and loculations are much less than previously quoted in the literature. ConclusionThis case review adds to the large body of evidence that IPCs are safe and have minimal complications in the palliation of symptoms of malignant pleural effusion.

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Malignant pleural effusion management: keeping the flood gates shut

Cited by 32 publications

References 47 publications

Molecular Profiling of Malignant Pleural Effusions with Next Generation Sequencing (NGS): Evidence that Supports Its Role in Cancer Management

Molecular Profiling of Malignant Pleural Effusions with Next Generation Sequencing (NGS): Evidence that Supports Its Role in Cancer Management

Malignant Pleural Effusion: Diagnosis and Management

Indwelling pleural catheters for malignancy related pleural effusions

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