Abstract
Introduction: Malignant pleural effusion (MPE) is often present in patients with cancer at an advanced stage and its presence indicates short expected survival.
Objective: Investigate the impact of different pleural effusion treatment options on the survival of patients with MPE.
Methods: We conducted a retrospective study on 107 patients (metastatic lung and breast cancer) with proven MPE. A group of 56 patients was treated with talc pleurodesis (TP) and a control group of 51 patients was treated with serial thoracentesis. The patients were further divided into subgroups based on tumour type and ECOG performance status (PS) scale. The overall survival of different subgroups was compared.
Results: The patients who underwent TP had a longer median survival (MS) than the patients without such a treatment (n=56; MS=21.5 weeks and n=51; MS=9w, respectively; p<0.001). The best results were achieved in patients with PS 1 (n=16; MS=35.5w and n=10; MS=11w for the groups with and without TP, respectively; p<0.001) and PS 2, whereas TP was not effective in PS 3 patients (n=13; MS=10w and n=11; MS=7w for the groups with and without TP, respectively; p=0.08). The patients with the breast cancer showed a longer survival after TP than those with the lung cancer (n=12; MS=37.5w and n=44; MS=20w, respectively; p<0.001).
Conclusion: The patients treated with talc pleurodesis had significantly longer overall survival. Better results were achieved for the group with the breast cancer and for the groups with better PS. This may indicate that talc pleurodesis, apart from its symptomatic effect on the cessation of pleural effusion, may have a direct anti-tumour effect as well.
- © 2014 ERS