Contemporary best practice in the management of malignant pleural effusion
Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
SAGE Publications
Abstract
ENGLISH ABSTRACT: Malignant pleural effusion (MPE) affects more than 1 million people globally. There
is a dearth of evidence on the therapeutic approach to MPE, and not surprisingly a high degree
of variability in the management thereof.
We aimed to provide practicing clinicians with an overview of the current evidence on the
management of MPE, preferentially focusing on studies that report patient-related outcomes
rather than pleurodesis alone, and to provide guidance on how to approach individual cases.
A pleural intervention for MPE will perforce be palliative in nature. A therapeutic thoracentesis
provides immediate relief for most. It can be repeated, especially in patients with a slow
rate of recurrence and a short anticipated survival. Definitive interventions, individualized
according the patient’s wishes, performance status, prognosis and other considerations
(including the ability of the lung to expand) should be offered to the remainder of patients.
Chemical pleurodesis (achieved via intercostal drain or pleuroscopy) and indwelling pleural
catheter (IPC) have equal impact on patient-based outcomes, although patients treated with
IPC spend less time in hospital and have less need for repeat pleural drainage interventions.
Talc slurry via IPC is an attractive recently validated option for patients who do not have a
nonexpandable lung.
Description
CITATION: Koegelenberg, C. F. N., et al. 2018. Contemporary best practice in the management of malignant pleural effusion. Therapeutic Advances in Respiratory Disease, 12:1-13, doi:10.1177/
1753466618785098.
The original publication is available at https://journals.sagepub.com
The original publication is available at https://journals.sagepub.com
Keywords
Pleurodesis, Catheters, Lung cancer
Citation
Koegelenberg, C. F. N., et al. 2018. Contemporary best practice in the management of malignant pleural effusion. Therapeutic Advances in Respiratory Disease, 12:1-13, doi:10.1177/
1753466618785098