Pleurodesis in malignant pleural effusions: Outcome and predictors of success

Abstract

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.

Pleural Space Elastance and Its Relation to Success Rates of Pleurodesis in Malignant Pleural Effusion

“…Although LDH mean value in failed cases was higher than succeeded cases, the difference between them did not reach statistical significance (p=0.41). These results were in concordance with the results obtained in the study performed by Ferreiro et al [ 8 ], Yildirim et al [ 11 ], and Rafei et al [ 12 ], who found no correlation between the values of pleural fluid LDH and the success or failure of pleurodesis.…”

Thoracoscopic Talc Insufflation Versus Talc Slurry in Patients with Malignant Pleural Effusion

“…These factors were found to have a strong negative impact on the success of the procedure regardless of the method of pleurodesis used. Santos et al and Rafei et al in their studies (21,22) concluded that both age and gender have no significant effects over pleurodesis outcomes. This might be partially true regarding age as an independent factor.…”

Audit on bedside chemical pleurodesis in palliative care setting: Brunei experience

“…Procedure success and complete response to treatment was defined based on Rafei et al [4] works in 2015. Complete response is defined as the absence of fluid accumulation that requires repeated thoracocentesis/chest tube drainage in the follow up imaging (chest X-ray or CT thorax).…”