Improved Quality of Life in Patients with Malignant Pleural Effusion Following Videoassisted Thoracoscopic Talc Pleurodesis. Preliminary Results

• Published in: Anticancer research Vol. 32; no. 11; pp. 5131 - 5134
• Main Authors: BASSO, Stefano M. M, MAZZA, Francesco, MARZANO, Bernardo, SANTEUFEMIA, Davide A, CHIARA, Giordano B, LUMACHI, Franco
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01-11-2012
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Female; Humans; Male; Medical sciences; Middle Aged; Neoplasms; Pleural Effusion, Malignant - therapy; Pleurodesis - methods; Pneumology; Quality of Life; Talc - administration & dosage; Thoracic Surgery, Video-Assisted; Tumors; Tumors of the respiratory system and mediastinum; Human; VATS; Talc; advanced cancer; Malignant tumor; Malignant pleural effusion; Quality of life; Cancerology; talc pleurodesis; Pleural disease; Advanced stage; Endoscopy; Thoracoscopy; Cancer
• ISSN: 0250-7005; 1791-7530

Malignant pleural effusion (MPE) is a common, debilitating complication of several types of advanced malignancy, which may significantly reduce the quality of life of patients. There are several options to treat MPE, including thoracentesis, placement of a long-term indwelling pleural catheter and chemical pleurodesis. The best treatment is still debated, but talc remains the agent of choice to achieve pleurodesis. Forty-six patients (28 men and 18 women; median age 67 years, range 47-82 years) with MPE related to different malignancies underwent video-assisted thoracoscopy talc pleurodesis. There were 26 (56.5%) patients with non-small cell lung cancer, 8 (17.4%) with breast cancer, 7 (15.2%) with pleural mesothelioma and 5 (10.9%) with other malignancies. The average operative time was 28±8 minutes, and the duration of chest tube drainage was 9.4±4.1 days. Side-effects were mild (temporary pain, fever for 2-3 days), affecting only three (12%) patients. Two patients (8%) died during hospitalization, due to progression of disease. Overall, pre- and postoperative Karnofsky performance index (KI) and Medical Research Council (MRC) dyspnea score were 62.1±12.2 vs. 71.3±13.2 (p=0.014), and 4.2±0.8 vs. 2.7±1.0 (p<0.001), respectively. A significant relationship between total amount of preoperative pleural effusion and both KI (R=-0.54, p=0.002) and MRC (R=0.64, p=0.0001) was found. No correlation (p=NS, log-rank test) was found between preoperative KI or MRC and underlying malignancy related to MPE. In conclusion, thoracoscopic large-particle talc pleurodesis is a feasible and effective treatment for MPE, significantly improving quality of life of patients.