D. Liou1, D. Serna-Gallegos1, J. Chan1, J. Borgella1, H. J. Soukiasian1 1Cedars-Sinai Medical Center,Los Angeles, CA, USA
Introduction: Malignant pleural effusions (MPE) are commonly managed with either thoracoscopic placement of a tunneled pleural catheter (PC) for drainage or talc pleurodesis (TP). A variety of factors influence the decision regarding which treatment modality to pursue. Comparison of mortality associated with PC versus TP in patients with MPE has not been previously studied.
Methods: A retrospective review of our institutional lung cancer database was performed. Patients with metastatic cancer and MPE were analyzed. Demographic and clinical data were tabulated, including age, gender, site of primary cancer, method of MPE treatment, and mortality. Patients were grouped according to MPE treatment modality. Clinical variables were compared between the two treatment groups.
Results: A total of 766 patients with MPE treated by either PC or TP were included. 461 patients comprised the PC group and 305 the TP group. PC had a higher proportional of males compared to TP (49.7% vs. 38.0%, p<0.01). The predominant site of primary tumor in both groups was lung, followed by breast and gastrointestinal. PC had fewer primary lung (41.4% vs. 51.5%, p<0.01) and breast (12.1% vs. 19.3%, p<0.01) cancers compared to TP, but greater proportion of gastrointestinal (11.3% vs. 5.6%, p<0.01) and hepatobiliary (9.5% vs. 3.3%, p<0.01) tumors. 5-year survival was 12.5% in PC compared to 6.0% in TP (p<0.01).
Conclusion: Patients with metastatic cancer and MPE treated with PC had double the 5-year survival rate compared to patients treated with TP. Significant differences in gender and site of primary cancer were identified between the two treatment groups. Further research is warranted to investigate whether these factors contribute to the observed survival difference.
