Malignant Pleural Effusion: Prognostic Factors for Survival and Response to Chemical Pleurodesis in a Series of 120 Cases

Martínez‐Moragón, Eva; Aparicio, Jorge; Sanchis, José; Menéndez, Rosário; Rogado, M.C.; Sanchis, Francisca

doi:10.1159/000029240

Cited by 125 publications

(102 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pleurodesis causes elimination of pleural space and theoretically leading to permanent cessation of fluid collection as a result of the formation of fibrous adhesion between the lung and parietal pleura [6]. The efficacy of chemical pleurodesis rests mainly on the performance of an adequate technique allowing complete drainage of the pleural fluid, a total re-expansion of the underlying lung, and consistent adhesion of both pleural surfaces as defined by Martinez et al [7] The methods of pleurodesis include intrapleural instillation of a sclerosing agent using a chest tube or videothoracoscopy or surgical abrasion using dry gauze [8]. Both methods were shown to be of equal effectiveness [3].…”

Section: Introductionmentioning

confidence: 99%

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Rafei¹,

Jabak²,

Mina³

et al. 2015

Integr Cancer Sci Therap

View full text Add to dashboard Cite

Malignant pleural effusion is a common clinical problem in cancer patients. Many therapeutic techniques have been investigated, including pleurodesis. Little is known about the factors that may affect the success rate of such a procedure. The main objective of this study is to assess the success rates of pleurodesis performed on malignant pleural effusions in cancer patients at AUBMC and to identify the predictors of a successful pleurodesis. Patients diagnosed with malignant pleural effusions and who have undergone pleurodesis between years 2004 and 2013 at the American University of Beirut Medical Center were identified. Relevant information including patient, tumor and pleural effusion characteristics and outcome after pleurodesis was recorded. Data analysis was done to assess the success rate of pleurodesis as well as for the presence of statistically significant association between success of pleurodesis and the different clinical characteristics. Pleurodesis success rates were as follow: 17.7% had complete success, 12.9% had partial success, 40.3% had failed pleurodesis, 3.2% died shortly after pleurodesis, and 25.8% were lost to follow-up. When this failure rate was further analyzed in terms of the different clinical markers, only two parameters were found to be associated with different success rates of pleurodesis, namely the mean pH of the pleural fluid and the tube used to perform pleurodesis. The conclusions of this study will benefit future cancer patients presenting with malignant effusions. Based on this study's results a well as those of future studies, clinicians will cautiously plan the management of malignant pleural effusion and also refine the technique used.

show abstract

Section: Introductionmentioning

confidence: 99%

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Rafei¹,

Jabak²,

Mina³

et al. 2015

Integr Cancer Sci Therap

View full text Add to dashboard Cite

show abstract

“…(2) Among patients with malignant effusions, the mean survival time is 3-13 months. (3,4) Although many patients respond to adjuvant treatments, which can control the primary disease, the great majority improve only after palliative therapy designed to avoid recurrence of the effusion.…”

Section: Introductionmentioning

confidence: 99%

Pleurodese nos derrames pleurais malignos: um inquérito entre médicos em países da América do Sul e Central

et al. 2010

View full text Add to dashboard Cite

Objective: Pleurodesis is an effective alternative for the control of malignant pleural effusions. However, there is as yet no consensus regarding the indications for the procedure and the techniques employed therein. The objective of this study was to evaluate how pleurodesis is performed in South and Central America. Methods: Professionals who perform pleurodesis completed a questionnaire regarding the indications for the procedure, the techniques used therein, and the outcomes obtained. Results: Our sample comprised 147 respondents in Brazil, 49 in other South American countries, and 36 in Central America. More than 50% of the respondents reported performing pleurodesis only if pleural malignancy had been confirmed. However, scores on dyspnea and performance status scales were rarely used as indications for the procedure. Nearly 75% of the respondents in Brazil and in Central America preferred to perform pleurodesis only for recurrent effusions and stated that lung expansion should be 90-100%. Talc slurry, instilled via medium-sized chest tubes, was the agent most often employed. Thoracoscopy was performed in less than 25% of cases. Fever and chest pain were the most common side effects, and empyema occurred in ≤ 14% of cases. The mean survival time after the procedure was most often reported to be 6-12 months. Conclusions: There was considerable variation among the countries evaluated in terms of the indications for pleurodesis, techniques used, and outcomes. Talc slurry is the agent most commonly used, and thoracoscopy is the technique of choice in Brazil. Pleurodesis is an effective procedure that has few side effects, as evidenced by the low complication rates and high survival times.Keywords: Pleural effusion, malignant; Pleura; Pleurodesis. ResumoObjetivo: A pleurodese é uma alternativa eficaz no controle dos derrames pleurais malignos, mas existem controvérsias a respeito de sua indicação e técnica. O objetivo deste estudo foi avaliar como é realizada a pleurodese em países da América do Sul e Central. Métodos: Profissionais que realizam pleurodese responderam um questionário sobre critérios de indicação para pleurodese, técnicas utilizadas e desfechos. Resultados: Nossa amostra envolveu 147 profissionais no Brasil, 49 em outros países da América do Sul e 36 em países da América Central. Mais de 50% dos participantes realizavam pleurodese somente se confirmada a malignidade no derrame pleural. Entretanto, escalas de dispneia e de status de performance eram raramente utilizadas para indicar o procedimento. Aproximadamente 75% dos participantes no Brasil e na América Central preferiam realizar a pleurodese somente no caso de recidiva do derrame, e a expansão pulmonar deveria variar de 90% a 100%. O talco slurry foi o agente mais utilizado, instilado via drenos de calibre intermediário. A toracoscopia foi realizada em menos de 25% dos casos. Febre e dor torácica foram os efeitos adversos mais comuns, e empiema ocorreu em ≤ 14% dos casos. A média de sobrevida após o procedimento variou entre 6 e 12...

show abstract

“…The prognosis in this case is very poor, with reported 1-and 6-month mortality rates of 54% and 85%, respectively [32,33], and a mean survival time after effusion of Ͻ6 months [34,35], ranging from 2.5 months for patients with lung carcinoma to 7 months for patients with breast carcinoma [36]. The main symptoms at diagnosis are dyspnea, pain, and cough, and they might be present even with only a small amount of pleural fluid (Ͻ500 ml), dramatically affecting exercise ability and quality of life [37].…”

Section: Malignant Pleural Effusionmentioning

confidence: 95%

Indications and Developments of Video-Assisted Thoracic Surgery in the Treatment of Lung Cancer

Solli

Spaggiari

2007

The Oncologist

View full text Add to dashboard Cite

After completing this course, the reader will be able to:1. Discuss the role of thoracoscopy in the evaluation of pulmonary nodules and pleural effusion.2. Describe the role of thoracoscopy in the staging of lung cancer.3. Discuss the role of thoracoscopy in surgical resection of early-stage lung cancer.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTThe term video-assisted thoracic surgery (VATS) is used to describe a modern minimally invasive surgical technique that nowadays represents a valid alternative to open procedures (i.e., thoracotomy) for many chest diseases. The VATS approach is presently used in many intrathoracic disorders, but while well established in benign chest disease, its role continues to evolve regarding the management of lung cancer. It is currently considered for the evaluation and treatment of suspected (or known) pleural effusion and in the diagnosis of indeterminate pulmonary nodules, and it has a complementary role to standard cervical mediastinoscopy in the invasive staging of mediastinal lymph nodes. It has also become an accepted approach for resection of peripheral early-stage lung cancer (stage I) in many centers worldwide and considerable experience has been accumulated in respect to this field, but absolute indications have yet to be firmly defined. This paper reviews indications and current data regarding minimally invasive approaches for the staging and treatment of lung cancer.

show abstract

Malignant Pleural Effusion: Prognostic Factors for Survival and Response to Chemical Pleurodesis in a Series of 120 Cases

Cited by 125 publications

References 16 publications

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Pleurodese nos derrames pleurais malignos: um inquérito entre médicos em países da América do Sul e Central

Indications and Developments of Video-Assisted Thoracic Surgery in the Treatment of Lung Cancer

Contact Info

Product

Resources

About