Management of malignant pleural effusion

Chen, Hongbin; Brahmer, Julie R.

doi:10.1007/s11912-008-0045-4

Cited by 27 publications

(17 citation statements)

References 28 publications

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“…Although the two techniques are equally effective, thoracoscopic insufflations of talc has been found marginally superior to talc slurry in a recent phase III prospective study on 482 patients of lung cancer. [33] The risk of acute respiratory distress syndrome using talc is directly related to the dose, particle size or other factors related to its instillation. Larger particle size (more than 15 microns) has reduced the risk of this complication now days.…”

Section: Pleurodesismentioning

confidence: 99%

Diagnosis and management options in malignant pleural effusions

et al. 2017

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Malignant pleural effusion (MPE) denotes an advanced malignant disease process. Most of the MPE are metastatic involvement of the pleura from primary malignancy at lung, breast, and other body sites apart from lymphomas. The diagnosis of MPE has been traditionally made on cytological examination of pleural fluid and/or histological examination of pleural biopsy tissue that still remains the initial approach in these cases. There has been tremendous advancement in the diagnosis of MPE now a day with techniques i.e. characteristic Ultrasound and computed tomography features, image guided biopsies, fluorodeoxyglucose-positron emission tomography imaging, thoracoscopy with direct biopsy under vision, tumor marker studies and immunocytochemical analysis etc., that have made possible an early diagnosis of MPE. The management of MPE still remains a challenge to pulmonologist and oncologist. Despite having various modalities with better tolerance such as pleurodesis and indwelling pleural catheters etc., for long-term control, all the management approaches remain palliative to improve the quality of life and reduce symptoms. While choosing an appropriate management intervention, one should consider the clinical status of the patient, life expectancy, overall cost, availability and comparative institutional outcomes, etc.

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Section: Pleurodesismentioning

confidence: 99%

Diagnosis and management options in malignant pleural effusions

et al. 2017

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“…MPE can cause significant shortness of breath, and therefore treatment focuses mainly on palliation. In general, recurrent MPE is treated with the instillation of sterile talc into the pleural space, according to current guidelines [2,3,4,5]. Mean hospitalization duration for pleurodesis is 4-8 days [6].…”

Section: Introductionmentioning

confidence: 99%

The Use of Indwelling Pleural Catheters for the Management of Malignant Pleural Effusion - Direct Costs in a Dutch Hospital

et al. 2013

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Background: Indwelling pleural catheters (IPCs) are increasingly used in the treatment of malignant pleural effusion (MPE). In general, these catheters have been reported to manage MPE efficiently. Unfortunately, insurance companies in the Netherlands do not reimburse these catheters in either first-line treatment or following failed talc pleurodesis. Objectives: Investigation of direct costs of IPC placement. Methods: Retrospective analysis of a prospectively collected database. Direct costs for both catheters and vacuum bottles were calculated. Indicators for indirect costs such as adverse events and complications and the need for additional home care for drainage were registered. Results: Mean costs for IPC amounted to EUR 2,173 and were different between tumor types - mesothelioma: EUR 4,028, breast: EUR 2,204, lung: EUR 1,146 and other: EUR 1,841; p = 0.017. Four patients were admitted to hospital for treatment of complications. Mean costs for IPC placement was similar when inserted as frontline treatment and after failed pleurodesis. Approximately 75% of patients did not need any help from specialized home care. Conclusion: Direct costs for IPC placement turn out to be acceptable when compared with estimated hospitalization costs for pleurodesis treatment. Randomized controlled trials have to be performed to compare the cost-effectiveness of IPCs compared to pleurodesis.

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“…Malignant pleural effusion (MPE) is common in patients with advanced cancer [1]. The primary neoplasms that most frequently cause MPE are lung cancer in men and breast cancer in women.…”

Section: Introductionmentioning

confidence: 99%

Hepatic breast cancer dissemination after an iatrogenic hepatic laceration during talc pleurodesis: a case report

Bosch-Barrera¹,

Espinós²

2010

Int Arch Med

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BackgroundTalc pleurodesis is an effective treatment for malignant pleural effusion. We present a case of an asymptomatic hepatic laceration that occurred during pleurodesis in a breast cancer patient and led to hepatic tumor dissemination.DiscussionPleurodesis is a relatively safe procedure, although previous studies have described malignant invasion of scar tissue.ConclusionTo our knowledge, this is the first case report of tumor spread due to a liver puncture during talc pleurodesis in a breast cancer patient.

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Management of malignant pleural effusion

Cited by 27 publications

References 28 publications

Diagnosis and management options in malignant pleural effusions

Diagnosis and management options in malignant pleural effusions

The Use of Indwelling Pleural Catheters for the Management of Malignant Pleural Effusion - Direct Costs in a Dutch Hospital

Hepatic breast cancer dissemination after an iatrogenic hepatic laceration during talc pleurodesis: a case report

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