Prognostic factors for survival of symptomatic patients with malignant pleural effusion who underwent palliative talc pleurodesis

Background: Pleural carcinomatosis usually represents the final common pathway in several metastatic diseases, especially breast, ovarian, and colonic cancer, leading to malignant pleural effusion (MPE). This complication is common in several patients with advanced malignancy, and usually leads patients to suffer from significant dyspnea, which may reduce their quality of life. Several interventions have shown to be useful to palliate the symptoms, including video-assisted thoracoscopic (VATS) pleural drainage, and talc or chemical pleurodesis. In patients with MPE, pleurodesis prevents re-accumulation of the effusion and thereby of symptoms. There is no evidence for an increase in mortality following talc pleurodesis, but factors affecting survival of treated patients are unclear. The aim of this study was to evaluate prognostic factors for survival of symptomatic patients with MPE. Patients and methods: Thirty-five patients (median age 70 years, range 42-83 years) with MPE underwent VATS, evacuation of the pleural fluid, and talc pleurodesis. There were 25 (71.4%) males and 10 (28.6%) females, and the causes of MPE were breast or ovarian cancer, non-small cell lung carcinoma, and malignant pleural mesothelioma in 14, 12, and 9 cases, respectively. The relationship of factors to survival was analyzed by calculating the log-rank test using Kaplan-Meyer method. The Cox’s regression model was also used. Results: Overall, the mean follow-up was 9.8±8.7 months, while the median postoperative survival for the entire group was 15.5 months.. We did not find (log-rank test) any relationship between both gender (p=0.53) and underlying malignancy associated with MPE (p=0.89, 0.48, and 0.36 for secondary cancer, lung cancer, and mesothelioma, respectively) and survival. Similarly, no correlation was found (Cox’s regression) between both age of the patients (p=0.44) and quantity of pleural fluid (p=0.88) and survival. Conclusions: Our results show that the prognosis of patients with MPE who underwent palliative talc pleurodesis is independent of age, gender, type of malignancy, and amount of pleural effusion, suggesting the usefulness to treat all patients with symptomatic MPE.