Patient evaluation for rapid pleurodesis of malignant pleural effusions

Krochmal, Rebecca; Reddy, Chakravarthy; Yarmus, Lonny; Desai, Neeraj R.; Feller‐Kopman, David; Lee, Hans J.

doi:10.21037/jtd.2016.08.55

Cited by 19 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This method has previously been shown in two series to decrease hospital length of stay (mean 1.8-2 days), and duration of TPC use (mean 8-10 days) measured by time to pleurodesis while significantly improving dyspnea and quality of life in patients with MPE (86,87). However, from a cost utilization, this method may be the least cost-effective option (88).…”

Section: Rapid Pleurodesismentioning

confidence: 97%

See 1 more Smart Citation

Diagnosis and management of malignant pleural effusions: state of the art in 2017

Desai

Lee

2017

J. Thorac. Dis.

Self Cite

View full text Add to dashboard Cite

Malignant pleural effusion (MPE) is a known complication of both thoracic and extra thoracic malignancies. The presence of MPE regardless of the primary site translates into advanced stage disease.Diagnosis and management of MPE with the goals of palliation and improving quality of life poses a challenge for chest physicians. Recently, multiple studies have made attempts to answer questions regarding optimal management in various clinical scenarios. We will review the current evidence and available options for the management of MPE.

show abstract

Section: Rapid Pleurodesismentioning

confidence: 97%

“…However, from a cost utilization, this method may be the least cost-effective option (88). Overall pleurodesis rates in patients who underwent rapid pleurodesis with the combination method were 92% (86,87).…”

Section: Rapid Pleurodesismentioning

confidence: 99%

Diagnosis and management of malignant pleural effusions: state of the art in 2017

Desai

Lee

2017

J. Thorac. Dis.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Pleurodesis may prevent the repeated hospitalization of thoracocentesis, especially in patients with metastatic cancer with a long-life expectancy (Rafei et al, 2015;Burgers et al, 2008;Krochmal et al, 2016). Pleurodesis is performed when the lungs are fully expanded visualized from chest Xrays, and fluid production is <150 cc per day.…”

Section: Introductionmentioning

confidence: 99%

The Relationship of Amount of Pleural Fluid and Time of Pleurodesis with the Results of Pleurodesis in Malignant Pleural Effusions

Sutanto,

Sigit,

Kurniawan

2020

INDONES J MED

View full text Add to dashboard Cite

Background: Pleural effusion can be an early sign of lung cancer in more than 25% of cases. Lung cancer is the most common cause of malignant pleural effusion (MPE). Pleurodesis is performed when the amount of pleural fluid is <150 ml/day, but it is difficult as its productive nature. This study aimed to find the right time to perform pleurodesis on patients with MPE, which is expected to achieve optimal results. Subjects and Method: This was a cross-sectional study conducted at Dr. Moewardi Hospital, Surakarta, Central Java, from June to July 2020. The study subjects were 17 patients with malignant pleural effusion (MPE) diagnosed with lung cancer who underwent water seal drainage (WSD) and indicated for pleurodesis. The dependent variable was the success of the pleurodesis procedure. The independent variables were the amount of evacuated pleural fluid and the time of pleurodesis performed. The study instruments were diagnosis of lung cancer with anatomic pathology, measurement of the amount of pleural fluid, and posteroanterior chest X-ray evaluating the success of pleurodesis. The data were analyzed using Spearman correlation, ANOVA to determine the differences in the amount of pleural fluid at the first, second, and third hours, and continued with post hoc LSD analysis using SPSS 21. Results: The pleurodesis success rate had positive correlation with the amount of pleural fluid (r= 0.24; p= 0.345) and the time of pleurodesis performed at the first hour (r= 0.10; p= 0.701), second hour (r= 0.03; p= 0.921), and third hour (r= 0.41; p= 0.106). Pleurodesis performed at the second hour had the lowest amount of pleural fluid (Mean= 84.66; SD= 38.88), followed by third hour (Mean= 110.77; SD= 65.57), and first hour (Mean= 111.22; SD= 57.83), but the differences were not statistically significant (p= 0.285). Conclusion:The pleurodesis success rate has a positive correlation with the amount of pleural fluid and the time of pleurodesis, but it was not statistically significant. There is no significant difference in the amount of pleural fluid evacuated at the three different times of pleurodesis. The least amount of pleural fluid obtains at the second hour (14.00-22.00).

show abstract

“…7 Rapid pleurodesis, combining thoracoscopic-guided talc pleurodesis with IPC insertion during the same procedure, was demonstrated to have a 92% pleurodesis rate and a reduced hospital length of stay and duration of IPC use while improving dyspnea and quality of life. 31,32 In an effort to standardize the management of patients with MPE, the American Thoracic Society, Society of Thoracic Surgeons, and the Society of Thoracic Radiology have developed evidence-based recommendations for the treatment of this patient population. 33 Guidelines for the management of patients with MPE were first published by the American Thoracic Society in 2007, followed by the British Thoracic Society in 2010, and now are being updated based on the results of large multicenter randomized trials and other studies examining the evaluation and treatment of this patient population.…”

mentioning

confidence: 99%

The Updated ATS/STS/STR Clinical Practice Guidelines on the Management of Malignant Pleural Effusions: What Is New in 2018?

Rakesh

Gelzinis

2019

Journal of Cardiothoracic and Vascular Anesthesia

View full text Add to dashboard Cite

MALIGNANT PLEURAL effusion (MPE) is defined as the presence of malignant cells in the pleural fluid and when present is a sign of an advanced stage of either a thoracic or extrathoracic malignancy. MPE is suspected in patients with a history of advanced malignant disease who present with a recurrent pleural effusion that contains an elevated protein concentration with lymphocyte predominance. 1 MPE is a common complication, with an estimated incidence of >150,000 cases per year, with most arising from lung and breast cancer metastases, lymphoma, and gastrointestinal tumors, although MPE has been documented with most malignancies. 2 Once diagnosed, the median survival ranges from 4 to 7 months, depending on the type of malignancy, tumor characteristics, the extent of disease, comorbidities, and the composition of the MPE. 3 It is a very disabling condition, with a huge impact on quality of life. 1 Once diagnosed, the management goals for these patients include palliation and improving the patient's remaining quality of life. The challenge is predicting the individual's remaining life span. Studies using quality of life measures, such as the Karnofsky performance scale, have found that patients with low scores of <30 had a median survival of 1.1 months, whereas those with higher scores (>70) tended to have a longer median survival of 13.2 months. 3 Clive et al., using a simplified version of the Karnofsky scale known as the Eastern Cooperative Oncology Group (ECOG) scale, compared the use of this scale alone with the scale in conjunction with laboratory findings and tumor type and developed a score called the LENT score. 4 The components of the LENT score include lactate dehydrogenase levels in the pleural effusion, ECOG scale, the neutrophilto-lymphocyte ratio, and the tumor type. Those authors demonstrated that the LENT score was able to risk stratify patients into a low-risk group, with a median survival of 319 days; a moderate-risk group, with a mean survival of 130 days; and a high-risk group, with a mean survival of 44 days. The score also was found to be superior to the ECOG alone in predicting survival at 1, 3, and 6 months. 4

show abstract

Patient evaluation for rapid pleurodesis of malignant pleural effusions

Abstract: The rapid pleurodesis protocol should be considered a viable treatment option for select patients with symptomatic recurrent MPEs undergoing chemical pleurodesis.

Cited by 19 publications

References 25 publications

Diagnosis and management of malignant pleural effusions: state of the art in 2017

Diagnosis and management of malignant pleural effusions: state of the art in 2017

The Relationship of Amount of Pleural Fluid and Time of Pleurodesis with the Results of Pleurodesis in Malignant Pleural Effusions

The Updated ATS/STS/STR Clinical Practice Guidelines on the Management of Malignant Pleural Effusions: What Is New in 2018?

Contact Info

Product

Resources

About