A brief review about malignant pleural effusion

BACKGROUND: Lung and breast cancers are the most common metastatic tumors to the pleura. The presence of malignant pleural effusion indicates advanced disease, and primary goal in treatment should be palliation and the main approaches are drainage of the effusion by thoracocentesis with or without pleurodesis or drainage with permanent pleural catheters. METHODS: We undertook a review about this dispute by searching of the MEDLINE database and search term was malignant pleural effusion. RESULTS: In one unblinded trial 106 patients with malignant pleural effusion were randomly assigned to placement of an indwelling catheter or pleurodesis with talcum slurry via chest tube. No significant difference was found in dyspnea, chest pain or quality of life scores between the groups. Twelve patients in the talcum group required further pleural procedures compared with three in the indwelling catheter group; adverse effects(pleural infection- catheter blockage) were more common in the indwelling catheter group. In one randomized controlled trial, permanent pleural catheters were compared with talcum pleurodesis .Again there were no dramatic differences between two arms for symptoms relief. CONCLUSION: Multiple approaches are available to remove the effusion and prevent its reaccumulation. Selection of an approach depends on local expertise, practice patterns and the appropriate treatment in each case should be determined through discussion with the patient, with the goal of improving the quality of life and symptoms relief.

Keywords:

Malignant pleural effusion