Lung

, Volume 191, Issue 2, pp 165–175 | Cite as

Management of Malignant Pleural Effusion

Article

Abstract

Malignancy is one of the most common causes of pleural effusion. Malignant pleural effusion is defined by the presence of malignant cells in the pleural fluid. Development of malignant pleural effusion usually defines advanced malignancy. Pathophysiology of malignant pleural effusion is not fully understood and may involve complex interactions between the mesothelial and malignant cells. Investigations and management of patients with malignant pleural effusion require a multidisciplinary approach. In this review, current practice for management of patients with malignant pleural effusion will be discussed. In addition, imaging techniques will be covered, including the use of thoracic ultrasound and its role in image-guiding pleural procedures. Moreover, interventional techniques will be described, such as medical thoracoscopy, the use of indwelling pleural catheters, or surgery for investigation and management of malignant pleural effusion.

Keywords

Malignant Pleural effusion Lung cancer Pleurodesis Thoracoscopy 

Notes

Conflict of interest

None.

References

  1. 1.
    Light RW (2011) Pleural effusions. Med Clin North Am 95(6):1055–1070PubMedCrossRefGoogle Scholar
  2. 2.
    Bennett R, Maskell N (2005) Management of malignant pleural effusions. Curr Opin Pulm Med 11(4):296–300PubMedGoogle Scholar
  3. 3.
    Shaw P, Agarwal R (2005) Pleurodesis for malignant pleural effusions. Cochrane Database Syst Rev (1):CD002916Google Scholar
  4. 4.
    Heffner JE (2010) Management of the patient with a malignant pleural effusion. Semin Respir Crit Care Med 31(6):723–733PubMedCrossRefGoogle Scholar
  5. 5.
    Awasthi A, Gupta N, Srinivasan R, Nijhawan R, Rajwanshi A (2007) Cytopathological spectrum of unusual malignant pleural effusions at a tertiary care centre in north India. Cytopathology 18(1):28–32PubMedCrossRefGoogle Scholar
  6. 6.
    Heffner JE (2008) Diagnosis and management of malignant pleural effusions. Respirology 13(1):5–20PubMedGoogle Scholar
  7. 7.
    Heffner JE, Klein JS (2008) Recent advances in the diagnosis and management of malignant pleural effusions. Mayo Clin Proc 83(2):235–250PubMedGoogle Scholar
  8. 8.
    Roberts ME, Neville E, Berrisford RG, Antunes G, Ali NJ (2010) Management of a malignant pleural effusion: British Thoracic Society Pleural Disease Guideline 2010. Thorax 65(Suppl 2):ii32–ii40PubMedCrossRefGoogle Scholar
  9. 9.
    Burrows CM, Mathews WC, Colt HG (2000) Predicting survival in patients with recurrent symptomatic malignant pleural effusions: an assessment of the prognostic values of physiologic, morphologic, and quality of life measures of extent of disease. Chest 117(1):73–78PubMedCrossRefGoogle Scholar
  10. 10.
    Fernandez C, Martin C, Aranda I, Romero S (2000) Malignant transient pleural transudate: a sign of early lymphatic tumoral obstruction. Respiration 67(3):333–336PubMedCrossRefGoogle Scholar
  11. 11.
    Estenne M, Yernault JC, De Troyer A (1983) Mechanism of relief of dyspnea after thoracocentesis in patients with large pleural effusions. Am J Med 74(5):813–819PubMedCrossRefGoogle Scholar
  12. 12.
    Judson MA, Sahn SA (1995) Pulmonary physiologic abnormalities caused by pleural disease. Semin Respir Respir Crit Care Med 16:346–353CrossRefGoogle Scholar
  13. 13.
    Wang JS, Tseng CH (1995) Changes in pulmonary mechanics and gas exchange after thoracentesis on patients with inversion of a hemidiaphragm secondary to large pleural effusion. Chest 107(6):1610–1614PubMedCrossRefGoogle Scholar
  14. 14.
    Light RW, Stansbury DW, Brown SE (1986) The relationship between pleural pressures and changes in pulmonary function after therapeutic thoracentesis. Am Rev Respir Dis 133(4):658–661PubMedGoogle Scholar
  15. 15.
    Lee YC, Light RW, Musk AW (2000) Management of malignant pleural mesothelioma: a critical review. Curr Opin Pulm Med 6(4):267–274PubMedCrossRefGoogle Scholar
  16. 16.
    Bech C, Sorensen JB (2008) Polyneuropathy in a patient with malignant pleural mesothelioma: a paraneoplastic syndrome. J Thorac Oncol 3(11):1359–1360PubMedCrossRefGoogle Scholar
  17. 17.
    Kashyap AS, Kashyap S (2001) An elderly man with pleural effusion and abnormal behaviour. Postgrad Med J 77(908):407–413PubMedCrossRefGoogle Scholar
  18. 18.
    Banayan S, Hot A, Janier M, Ninet J, Zurlinden O, Billotey C (2006) Malignant mesothelioma of the peritoneum as the cause of a paraneoplastic syndrome: detection by 18F-FDG PET. Eur J Nucl Med Mol Imaging 33(6):751PubMedCrossRefGoogle Scholar
  19. 19.
    Perks WH, Crow JC, Green M (1978) Mesothelioma associated with the syndrome of inappropriate secretion of antidiuretic hormone. Am Rev Respir Dis 117(4):789–794PubMedGoogle Scholar
  20. 20.
    Balduyck B, Lauwers P, Govaert K, Hendriks J, De Maeseneer M, Van Schil P (2006) Solitary fibrous tumor of the pleura with associated hypoglycemia: Doege–Potter syndrome: a case report. J Thorac Oncol 1(6):588–590PubMedCrossRefGoogle Scholar
  21. 21.
    Beck JM (1998) Pleural disease in patients with acquired immune deficiency syndrome. Clin Chest Med 19(2):341–349PubMedCrossRefGoogle Scholar
  22. 22.
    Afessa B (2000) Pleural effusion and pneumothorax in hospitalized patients with HIV infection: the Pulmonary Complications, ICU support, and Prognostic Factors of Hospitalized Patients with HIV (PIP) Study. Chest 117(4):1031–1037PubMedCrossRefGoogle Scholar
  23. 23.
    Afessa B (2001) Pleural effusions and pneumothoraces in AIDS. Curr Opin Pulm Med 7(4):202–209PubMedCrossRefGoogle Scholar
  24. 24.
    Porcel JM, Civit MC, Bielsa S, Light RW (2012) Contarini’s syndrome: bilateral pleural effusion, each side from different causes. J Hosp Med 7(2):164–165PubMedCrossRefGoogle Scholar
  25. 25.
    Lawton F, Blackledge G, Johnson R (1985) Co-existent chylous and serous pleural effusions associated with ovarian cancer: a case report of Contarini’s syndrome. Eur J Surg Oncol 11(2):177–178PubMedGoogle Scholar
  26. 26.
    Kutty CP, Varkey B (1978) “Contarini’s condition:” bilateral pleural effusions with markedly different characteristics. Chest 74(6):679–680PubMedCrossRefGoogle Scholar
  27. 27.
    McGrath EE, Anderson PB (2011) Diagnosis of pleural effusion: a systematic approach. Am J Crit Care 20(2):119–127PubMedCrossRefGoogle Scholar
  28. 28.
    Lee YC, Light RW (2004) Management of malignant pleural effusions. Respirology 9(2):148–156PubMedCrossRefGoogle Scholar
  29. 29.
    Hooper C, Lee YC, Maskell N (2010) Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax 65(Suppl 2):ii4–17PubMedCrossRefGoogle Scholar
  30. 30.
    Koenig SJ, Narasimhan M, Mayo PH (2011) Thoracic ultrasonography for the pulmonary specialist. Chest 140(5):1332–1341PubMedCrossRefGoogle Scholar
  31. 31.
    Mayo PH, Doelken P (2006) Pleural ultrasonography. Clin Chest Med 27(2):215–227PubMedCrossRefGoogle Scholar
  32. 32.
    Kastelik JA, Alhajji M, Faruqi S, Teoh R, Arnold AG (2009) Thoracic ultrasound: an important skill for respiratory physicians. Thorax 64(9):825–826PubMedCrossRefGoogle Scholar
  33. 33.
    Qureshi NR, Rahman NM, Gleeson FV (2009) Thoracic ultrasound in the diagnosis of malignant pleural effusion. Thorax 64(2):139–143PubMedCrossRefGoogle Scholar
  34. 34.
    Havelock T, Teoh R, Laws D, Gleeson F (2010) Pleural procedures and thoracic ultrasound: British Thoracic Society Pleural Disease Guideline 2010. Thorax 65(Suppl 2):ii61–ii76PubMedCrossRefGoogle Scholar
  35. 35.
    Duncan DR, Morgenthaler TI, Ryu JH, Daniels CE (2009) Reducing iatrogenic risk in thoracentesis: establishing best practice via experiential training in a zero-risk environment. Chest 135(5):1315–1320PubMedCrossRefGoogle Scholar
  36. 36.
    Barnes TW, Morgenthaler TI, Olson EJ, Hesley GK, Decker PA, Ryu JH (2005) Sonographically guided thoracentesis and rate of pneumothorax. J Clin Ultrasound 33(9):442–446PubMedCrossRefGoogle Scholar
  37. 37.
    Seneff MG, Corwin RW, Gold LH, Irwin RS (1986) Complications associated with thoracocentesis. Chest 90(1):97–100PubMedCrossRefGoogle Scholar
  38. 38.
    Jones PW, Moyers JP, Rogers JT, Rodriguez RM, Lee YC, Light RW (2003) Ultrasound-guided thoracentesis: is it a safer method? Chest 123(2):418–423PubMedCrossRefGoogle Scholar
  39. 39.
    Wrightson JM, Helm EJ, Rahman NM, Gleeson FV, Davies RJ (2009) Pleural procedures and pleuroscopy. Respirology 14(6):796–807PubMedCrossRefGoogle Scholar
  40. 40.
    Heidecker J, Huggins JT, Sahn SA, Doelken P (2006) Pathophysiology of pneumothorax following ultrasound-guided thoracentesis. Chest 130(4):1173–1184PubMedCrossRefGoogle Scholar
  41. 41.
    Rahman NM, Singanayagam A, Davies HE, Wrightson JM, Mishra EK, Lee YC et al (2010) Diagnostic accuracy, safety and utilisation of respiratory physician-delivered thoracic ultrasound. Thorax 65(5):449–453PubMedCrossRefGoogle Scholar
  42. 42.
    Hooper CE, Lee YC, Maskell NA (2010) Setting up a specialist pleural disease service. Respirology 15(7):1028–1036PubMedCrossRefGoogle Scholar
  43. 43.
    Erasmus JJ, McAdams HP, Rossi SE, Goodman PC, Coleman RE, Patz EF (2010) FDG PET of pleural effusions in patients with non-small cell lung cancer. AJR Am J Roentgenol 175(1):245–249CrossRefGoogle Scholar
  44. 44.
    Truong MT, Viswanathan C, Erasmus JJ (2011) Positron emission tomography/computed tomography in lung cancer staging, prognosis, and assessment of therapeutic response. J Thorac Imaging 26(2):132–146PubMedCrossRefGoogle Scholar
  45. 45.
    Gill RR (2011) Imaging of mesothelioma. Recent Results Cancer Res 189:27–43PubMedCrossRefGoogle Scholar
  46. 46.
    Genestreti G, Moretti A, Piciucchi S, Giovannini N, Galassi R, Scarpi E et al (2012) FDG PET/CT response evaluation in malignant pleural mesothelioma patients treated with talc pleurodesis and chemotherapy. J Cancer 3:241–245PubMedCrossRefGoogle Scholar
  47. 47.
    Duranti L, Leo F, Pastorino U (2012) PET scan contribution in chest tumor management: a systematic review for thoracic surgeons. Tumori 98(2):175–184PubMedGoogle Scholar
  48. 48.
    Helm EJ, Matin TN, Gleeson FV (2010) Imaging of the pleura. J Magn Reson Imaging 32(6):1275–1286PubMedCrossRefGoogle Scholar
  49. 49.
    Leung AN, Muller NL, Miller RR (1990) CT in differential diagnosis of diffuse pleural disease. AJR Am J Roentgenol 154(3):487–492PubMedCrossRefGoogle Scholar
  50. 50.
    Metintas M, Ucgun I, Elbek O, Erginel S, Metintas S, Kolsuz M et al (2002) Computed tomography features in malignant pleural mesothelioma and other commonly seen pleural diseases. Eur J Radiol 41(1):1–9PubMedCrossRefGoogle Scholar
  51. 51.
    Evans AL, Gleeson FV (2004) Radiology in pleural disease: state of the art. Respirology 9(3):300–312PubMedCrossRefGoogle Scholar
  52. 52.
    Falaschi F, Battolla L, Mascalchi M, Cioni R, Zampa V, Lencioni R et al (1996) Usefulness of MR signal intensity in distinguishing benign from malignant pleural disease. AJR Am J Roentgenol 166(4):963–968PubMedCrossRefGoogle Scholar
  53. 53.
    Sahn SA (2012) Getting the most from pleural fluid analysis. Respirology 17(2):270–277PubMedCrossRefGoogle Scholar
  54. 54.
    Rahman NM, Mishra EK, Davies HE, Davies RJ, Lee YC (2008) Clinically important factors influencing the diagnostic measurement of pleural fluid pH and glucose. Am J Respir Crit Care Med 178(5):483–490PubMedCrossRefGoogle Scholar
  55. 55.
    Fahim A, Kastelik JA (2010) The utility of pleural amylase measurement in metastatic mucinous adenocarcinoma. J R Coll Physicians Edinb 40(2):119–120PubMedCrossRefGoogle Scholar
  56. 56.
    Rodriguez-Panadero F, Lopez MJ (1989) Low glucose and pH levels in malignant pleural effusions. Diagnostic significance and prognostic value in respect to pleurodesis. Am Rev Respir Dis 139(3):663–667PubMedGoogle Scholar
  57. 57.
    Rodriguez-Panadero F, Lopez-Mejias J (1989) Survival time of patients with pleural metastatic carcinoma predicted by glucose and pH studies. Chest 95(2):320–324PubMedCrossRefGoogle Scholar
  58. 58.
    Martinez-Garcia MA, Cases-Viedma E, Cordero-Rodriguez PJ, Hidalgo-Ramirez M, Perpina-Tordera M, Sanchis-Moret F et al (2000) Diagnostic utility of eosinophils in the pleural fluid. Eur Respir J 15(1):166–169PubMedCrossRefGoogle Scholar
  59. 59.
    Ferreiro L, San Jose E, Gonzalez-Barcala FJ, Alvarez-Dobano JM, Golpe A, Gude F et al (2011) Eosinophilic pleural effusion: incidence, etiology and prognostic significance. Arch Bronconeumol 47(10):504–509PubMedCrossRefGoogle Scholar
  60. 60.
    Oba Y, Abu-Salah T (2012) The prevalence and diagnostic significance of eosinophilic pleural effusions: a meta-analysis and systematic review. Respiration 83(3):198–208PubMedCrossRefGoogle Scholar
  61. 61.
    Husain AN, Colby TV, Ordonez NG, Krausz T, Borczuk A, Cagle PT et al (2009) Guidelines for pathologic diagnosis of malignant mesothelioma: a consensus statement from the International Mesothelioma Interest Group. Arch Pathol Lab Med 133(8):1317–1331PubMedGoogle Scholar
  62. 62.
    Pinelli V, Laroumagne S, Sakr L, Marchetti GP, Tassi GF, Astoul P (2012) Pleural fluid cytological yield and visceral pleural invasion in patients with epithelioid malignant pleural mesothelioma. J Thorac Oncol 7(3):595–598PubMedCrossRefGoogle Scholar
  63. 63.
    Agrawal V, Doelken P, Sahn SA (2008) Pleural fluid analysis in chylous pleural effusion. Chest 133(6):1436–1441PubMedCrossRefGoogle Scholar
  64. 64.
    McGrath EE, Blades Z, Anderson PB (2010) Chylothorax: aetiology, diagnosis and therapeutic options. Respir Med 104(1):1–8PubMedCrossRefGoogle Scholar
  65. 65.
    Huggins JT (2010) Chylothorax and cholesterol pleural effusion. Semin Respir Crit Care Med 31(6):743–750PubMedCrossRefGoogle Scholar
  66. 66.
    Davies HE, Sadler RS, Bielsa S, Maskell NA, Rahman NM, Davies RJ et al (2009) Clinical impact and reliability of pleural fluid mesothelin in undiagnosed pleural effusions. Am J Respir Crit Care Med 180(5):437–444PubMedCrossRefGoogle Scholar
  67. 67.
    Bielsa S, Esquerda A, Salud A, Montes A, Arellano E, Rodriguez-Panadero F et al (2009) High levels of tumor markers in pleural fluid correlate with poor survival in patients with adenocarcinomatous or squamous malignant effusions. Eur J Intern Med 20(4):383–386PubMedCrossRefGoogle Scholar
  68. 68.
    Gaspar MJ, De Miguel J, Garcia Diaz JD, Diez M (2008) Clinical utility of a combination of tumour markers in the diagnosis of malignant pleural effusions. Anticancer Res 28(5B):2947–2952PubMedGoogle Scholar
  69. 69.
    Creaney J, Robinson BW (2009) Serum and pleural fluid biomarkers for mesothelioma. Curr Opin Pulm Med 15(4):366–370PubMedCrossRefGoogle Scholar
  70. 70.
    Creaney J, Francis RJ, Dick IM, Musk AW, Robinson BW, Byrne MJ et al (2011) Serum soluble mesothelin concentrations in malignant pleural mesothelioma: relationship to tumor volume, clinical stage and changes in tumor burden. Clin Cancer Res 17(5):1181–1189PubMedCrossRefGoogle Scholar
  71. 71.
    Hollevoet K, Reitsma JB, Creaney J, Grigoriu BD, Robinson BW, Scherpereel A et al (2012) Serum mesothelin for diagnosing malignant pleural mesothelioma: an individual patient data meta-analysis. J Clin Oncol 30(13):1541–1549PubMedCrossRefGoogle Scholar
  72. 72.
    Porcel JM, Esquerda A, Rodriguez-Panadero F, Martinez-Iribarren A, Bielsa S (2011) The use of pleural fluid sCD44v6/std ratio for distinguishing mesothelioma from other pleural malignancies. J Thorac Oncol 6(1):190–194PubMedCrossRefGoogle Scholar
  73. 73.
    van der Bij S, Schaake E, Koffijberg H, Burgers JA, de Mol BA, Moons KG (2011) Markers for the non-invasive diagnosis of mesothelioma: a systematic review. Br J Cancer 104(8):1325–1333PubMedCrossRefGoogle Scholar
  74. 74.
    Hooper CE, Elvers KT, Welsh GI, Millar AB, Maskell NA (2012) VEGF and sVEGFR-1 in malignant pleural effusions: association with survival and pleurodesis outcomes. Lung Cancer 77(2):443–449PubMedCrossRefGoogle Scholar
  75. 75.
    Sriram KB, Relan V, Clarke BE, Duhig EE, Yang IA, Bowman RV et al (2011) Diagnostic molecular biomarkers for malignant pleural effusions. Future Oncol 7(6):737–752PubMedCrossRefGoogle Scholar
  76. 76.
    Garcia LW, Ducatman BS, Wang HH (1994) The value of multiple fluid specimens in the cytological diagnosis of malignancy. Mod Pathol 7(6):665–668PubMedGoogle Scholar
  77. 77.
    Swiderek J, Morcos S, Donthireddy V, Surapaneni R, Jackson-Thompson V, Schultz L et al (2010) Prospective study to determine the volume of pleural fluid required to diagnose malignancy. Chest 137(1):68–73PubMedCrossRefGoogle Scholar
  78. 78.
    Dekker A, Bupp PA (1978) Cytology of serous effusions. An investigation into the usefulness of cell blocks versus smears. Am J Clin Pathol 70(6):855–860PubMedGoogle Scholar
  79. 79.
    Nguyen KS, Neal JW (2012) First-line treatment of EGFR-mutant non-small-cell lung cancer: the role of erlotinib and other tyrosine kinase inhibitors. Biologics 6:337–344PubMedGoogle Scholar
  80. 80.
    Gridelli C, Ciardiello F, Gallo C, Feld R, Butts C, Gebbia V et al (2012) First-line erlotinib followed by second-line cisplatin-gemcitabine chemotherapy in advanced non-small-cell lung cancer: the TORCH randomized trial. J Clin Oncol 30(24):3002–3011PubMedCrossRefGoogle Scholar
  81. 81.
    Salyer WR, Eggleston JC, Erozan YS (1975) Efficacy of pleural needle biopsy and pleural fluid cytopathology in the diagnosis of malignant neoplasm involving the pleura. Chest 67(5):536–539PubMedCrossRefGoogle Scholar
  82. 82.
    Escudero BC, Garcia CM, Cuesta CB, Molinos ML, Rodriguez RS, Gonzalez PA et al (1990) Cytologic and bacteriologic analysis of fluid and pleural biopsy specimens with Cope’s needle. Study of 414 patients. Arch Intern Med 150(6):1190–1194CrossRefGoogle Scholar
  83. 83.
    Frist B, Kahan AV, Koss LG (1979) Comparison of the diagnostic values of biopsies of the pleura and cytologic evaluation of pleural fluids. Am J Clin Pathol 72(1):48–51PubMedGoogle Scholar
  84. 84.
    Chen NH, Hsieh IC, Tsao TC (1997) Comparison of the clinical diagnostic value between pleural needle biopsy and analysis of pleural effusion. Changgeng Yi Xue Za Zhi 20(1):11–16PubMedGoogle Scholar
  85. 85.
    Prakash UB, Reiman HM (1985) Comparison of needle biopsy with cytologic analysis for the evaluation of pleural effusion: analysis of 414 cases. Mayo Clin Proc 60(3):158–164PubMedCrossRefGoogle Scholar
  86. 86.
    Von Hoff DD, LiVolsi V (1975) Diagnostic reliability of needle biopsy of the parietal pleura. A review of 272 biopsies. Am J Clin Pathol 64(2):200–203Google Scholar
  87. 87.
    Salyer WR, Eggleston JC, Erozan YS (1980) Comparison of the diagnostic values of pleural biopsies and cytologic evaluation of pleural fluids. Am J Clin Pathol 73(2):289PubMedGoogle Scholar
  88. 88.
    Maskell NA, Gleeson FV, Davies RJ (2003) Standard pleural biopsy versus CT-guided cutting-needle biopsy for diagnosis of malignant disease in pleural effusions: a randomised controlled trial. Lancet 361(9366):1326–1330PubMedCrossRefGoogle Scholar
  89. 89.
    Adams RF, Gray W, Davies RJ, Gleeson FV (2001) Percutaneous image-guided cutting needle biopsy of the pleura in the diagnosis of malignant mesothelioma. Chest 120(6):1798–1802PubMedCrossRefGoogle Scholar
  90. 90.
    Rahman NM, Ali NJ, Brown G, Chapman SJ, Davies RJ, Downer NJ et al (2010) Local anaesthetic thoracoscopy: British Thoracic Society Pleural Disease Guideline 2010. Thorax 65(Suppl 2):ii54–ii60PubMedCrossRefGoogle Scholar
  91. 91.
    Rodriguez-Panadero F (2008) Medical thoracoscopy. Respiration 76(4):363–372PubMedCrossRefGoogle Scholar
  92. 92.
    Rodriguez-Panadero F, Janssen JP, Astoul P (2006) Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion. Eur Respir J 28(2):409–422PubMedCrossRefGoogle Scholar
  93. 93.
    Yim AP, Izzat MB, Lee TW, Wan S (1999) Video-assisted thoracic surgery: a renaissance in surgical therapy. Respirology 4(1):1–8PubMedCrossRefGoogle Scholar
  94. 94.
    Froudarakis ME, Noppen M (2009) Medical thoracoscopy: new tricks for an old trade. Respiration 78(4):373–374PubMedCrossRefGoogle Scholar
  95. 95.
    Froudarakis ME (2011) New challenges in medical thoracoscopy. Respiration 82(2):197–200PubMedCrossRefGoogle Scholar
  96. 96.
    Munavvar M, Khan MA, Edwards J, Waqaruddin Z, Mills J (2007) The autoclavable semirigid thoracoscope: the way forward in pleural disease? Eur Respir J 29(3):571–574PubMedCrossRefGoogle Scholar
  97. 97.
    Lee P, Hsu A, Lo C, Colt HG (2007) Prospective evaluation of flex-rigid pleuroscopy for indeterminate pleural effusion: accuracy, safety and outcome. Respirology 12(6):881–886PubMedCrossRefGoogle Scholar
  98. 98.
    Tassi GF, Davies RJ, Noppen M (2006) Advanced techniques in medical thoracoscopy. Eur Respir J 28(5):1051–1059PubMedCrossRefGoogle Scholar
  99. 99.
    Tassi GF, Marchetti GP, Aliprandi PL (2011) Advanced medical thoracoscopy. Monaldi Arch Chest Dis 75(1):99–101PubMedGoogle Scholar
  100. 100.
    Tassi G, Marchetti G (2003) Minithoracoscopy: a less invasive approach to thoracoscopy. Chest 124(5):1975–1977PubMedCrossRefGoogle Scholar
  101. 101.
    Greillier L, Cavailles A, Fraticelli A, Scherpereel A, Barlesi F, Tassi G et al (2007) Accuracy of pleural biopsy using thoracoscopy for the diagnosis of histologic subtype in patients with malignant pleural mesothelioma. Cancer 110(10):2248–2252PubMedCrossRefGoogle Scholar
  102. 102.
    Kolschmann S, Ballin A, Gillissen A (2005) Clinical efficacy and safety of thoracoscopic talc pleurodesis in malignant pleural effusions. Chest 128(3):1431–1435PubMedCrossRefGoogle Scholar
  103. 103.
    Gondker A, Pathmanathan S, Kastelik J (2011) Practical procedures: chemical pleurodesis—what is it & how to do it. Found Years J 5(9):88–92Google Scholar
  104. 104.
    Rodriguez-Panadero F, Montes-Worboys A (2012) Mechanisms of pleurodesis. Respiration 83(2):91–98PubMedCrossRefGoogle Scholar
  105. 105.
    Rodriguez-Panadero F, Segado A, Martin JJ, Ayerbe R, Torres GI, Castillo J (1995) Failure of talc pleurodesis is associated with increased pleural fibrinolysis. Am J Respir Crit Care Med 151(3 Pt 1):785–790PubMedGoogle Scholar
  106. 106.
    Schwarz Y, Star A (2012) Role of talc modulation on cytokine activation in cancer patients undergoing pleurodesis. Pulm Med 2012:806183. Epub 2012 Mar 7Google Scholar
  107. 107.
    Maskell NA, Lee YC, Gleeson FV, Hedley EL, Pengelly G, Davies RJ (2004) Randomized trials describing lung inflammation after pleurodesis with talc of varying particle size. Am J Respir Crit Care Med 170(4):377–382PubMedCrossRefGoogle Scholar
  108. 108.
    Fraticelli A, Robaglia-Schlupp A, Riera H, Monjanel-Mouterde S, Cau P, Astoul P (2002) Distribution of calibrated talc after intrapleural administration: an experimental study in rats. Chest 122(5):1737–1741PubMedCrossRefGoogle Scholar
  109. 109.
    Maceachern P, Tremblay A (2011) Pleural controversy: pleurodesis versus indwelling pleural catheters for malignant effusions. Respirology 16(5):747–754PubMedCrossRefGoogle Scholar
  110. 110.
    Davies HE, Mishra EK, Kahan BC, Wrightson JM, Stanton AE, Guhan A et al (2012) Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial. JAMA 307(22):2383–2389PubMedGoogle Scholar
  111. 111.
    Spiegler PA, Hurewitz AN, Groth ML (2003) Rapid pleurodesis for malignant pleural effusions. Chest 123(6):1895–1898PubMedCrossRefGoogle Scholar
  112. 112.
    Goodman A, Davies CW (2006) Efficacy of short-term versus long-term chest tube drainage following talc slurry pleurodesis in patients with malignant pleural effusions: a randomised trial. Lung Cancer 54(1):51–55PubMedCrossRefGoogle Scholar
  113. 113.
    Bielsa S, Hernandez P, Rodriguez-Panadero F, Taberner T, Salud A, Porcel JM (2011) Tumor type influences the effectiveness of pleurodesis in malignant effusions. Lung 189(2):151–155PubMedCrossRefGoogle Scholar
  114. 114.
    Dresler CM, Olak J, Herndon JE, Richards WG, Scalzetti E, Fleishman SB et al (2005) Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion. Chest 127(3):909–915PubMedCrossRefGoogle Scholar
  115. 115.
    Janssen JP, Collier G, Astoul P, Tassi GF, Noppen M, Rodriguez-Panadero F et al (2007) Safety of pleurodesis with talc poudrage in malignant pleural effusion: a prospective cohort study. Lancet 369(9572):1535–1539PubMedCrossRefGoogle Scholar
  116. 116.
    Huggins JT, Sahn SA, Heidecker J, Ravenel JG, Doelken P (2007) Characteristics of trapped lung: pleural fluid analysis, manometry, and air-contrast chest CT. Chest 131(1):206–213PubMedCrossRefGoogle Scholar
  117. 117.
    Puri V, Pyrdeck TL, Crabtree TD, Kreisel D, Krupnick AS, Colditz GA et al (2012) Treatment of malignant pleural effusion: a cost-effectiveness analysis. Ann Thorac Surg 94(2):374–380PubMedCrossRefGoogle Scholar
  118. 118.
    Tremblay A, Mason C, Michaud G (2007) Use of tunnelled catheters for malignant pleural effusions in patients fit for pleurodesis. Eur Respir J 30(4):759–762PubMedCrossRefGoogle Scholar
  119. 119.
    Tremblay A, Michaud G (2006) Single-center experience with 250 tunnelled pleural catheter insertions for malignant pleural effusion. Chest 129(2):362–368PubMedCrossRefGoogle Scholar
  120. 120.
    Bibby AC, Maskell NA (2011) Pleural procedures: intercostal chest drains and indwelling pleural catheters. Br J Hosp Med (Lond) 72(6):331–335Google Scholar
  121. 121.
    Van Meter ME, McKee KY, Kohlwes RJ (2011) Efficacy and safety of tunneled pleural catheters in adults with malignant pleural effusions: a systematic review. J Gen Intern Med 26(1):70–76PubMedCrossRefGoogle Scholar
  122. 122.
    Putnam JB Jr, Light RW, Rodriguez RM, Ponn R, Olak J, Pollak JS et al (1999) A randomized comparison of indwelling pleural catheter and doxycycline pleurodesis in the management of malignant pleural effusions. Cancer 86(10):1992–1999PubMedCrossRefGoogle Scholar
  123. 123.
    Demmy TL, Gu L, Burkhalter JE, Toloza EM, D’Amico TA, Sutherland S et al (2012) Optimal management of malignant pleural effusions (results of CALGB 30102). J Natl Compr Canc Netw 10(8):975–982PubMedGoogle Scholar
  124. 124.
    Reddy C, Ernst A, Lamb C, Feller-Kopman D (2011) Rapid pleurodesis for malignant pleural effusions: a pilot study. Chest 139(6):1419–1423PubMedCrossRefGoogle Scholar
  125. 125.
    Zarogoulidis P, Chatzaki E, Hohenforst-Schmidt W, Goldberg EP, Galaktidou G, Kontakiotis T et al (2012) Management of malignant pleural effusion by suicide gene therapy in advanced stage lung cancer: a case series and literature review. Cancer Gene Ther 19(9):593–600PubMedCrossRefGoogle Scholar
  126. 126.
    Morgensztern D, Waqar S, Subramanian J, Trinkaus K, Govindan R (2012) Prognostic impact of malignant pleural effusion at presentation in patients with metastatic non-small-cell lung cancer. J Thorac Oncol 7(10):1485–1489PubMedCrossRefGoogle Scholar
  127. 127.
    Gonzalez-Angulo AM, Morales-Vasquez F, Hortobagyi GN (2007) Overview of resistance to systemic therapy in patients with breast cancer. Adv Exp Med Biol 608:1–22PubMedCrossRefGoogle Scholar
  128. 128.
    Rastelli F, Crispino S (2008) Factors predictive of response to hormone therapy in breast cancer. Tumori 94(3):370–383PubMedGoogle Scholar
  129. 129.
    Hind D, Ward S, De Nigris E, Simpson E, Carroll C, Wyld L (2007) Hormonal therapies for early breast cancer: systematic review and economic evaluation. Health Technol Assess 11(26):iii–xiPubMedGoogle Scholar
  130. 130.
    El Saghir NS, Tfayli A, Hatoum HA, Nachef Z, Dinh P, Awada A (2011) Treatment of metastatic breast cancer: state-of-the-art, subtypes and perspectives. Crit Rev Oncol Hematol 80(3):433–449PubMedCrossRefGoogle Scholar
  131. 131.
    Barton S, Swanton C (2011) Recent developments in treatment stratification for metastatic breast cancer. Drugs 71(16):2099–2113PubMedCrossRefGoogle Scholar
  132. 132.
    Carey LA (2010) Directed therapy of subtypes of triple-negative breast cancer. Oncologist 15(Suppl 5):49–56PubMedCrossRefGoogle Scholar
  133. 133.
    Santos GT, Prolla JC, Camillo ND, Zavalhia LS, Ranzi AD, Bica CG (2012) Clinical and pathological factors influencing the survival of breast cancer patients with malignant pleural effusion. J Bras Pneumol 38(4):487–493PubMedCrossRefGoogle Scholar
  134. 134.
    Koo JS, Jung W, Jeong J (2010) Metastatic breast cancer shows different immunohistochemical phenotype according to metastatic site. Tumori 96(3):424–432PubMedGoogle Scholar
  135. 135.
    Pokieser W, Cassik P, Fischer G, Vesely M, Ulrich W, Peters-Engl C (2004) Malignant pleural and pericardial effusion in invasive breast cancer: impact of the site of the primary tumor. Breast Cancer Res Treat 83(2):139–142PubMedCrossRefGoogle Scholar
  136. 136.
    Kido H, Morizane C, Tamura T, Hagihara A, Kondo S, Ueno H et al (2012) Gemcitabine-induced pleuropericardial effusion in a patient with pancreatic cancer. Jpn J Clin Oncol 42(9):845–850PubMedCrossRefGoogle Scholar
  137. 137.
    Whitworth JM, Schneider KE, Fauci JM, Bryant AS, Cerfolio RJ, Straughn JM Jr (2012) Outcomes of patients with gynecologic malignancies undergoing video-assisted thoracoscopic surgery (VATS) and pleurodesis for malignant pleural effusion. Gynecol Oncol 125(3):646–648PubMedCrossRefGoogle Scholar
  138. 138.
    Hirata T, Yonemori K, Hirakawa A, Shimizu C, Tamura K, Ando M et al (2011) Efficacy of pleurodesis for malignant pleural effusions in breast cancer patients. Eur Respir J 38(6):1425–1430PubMedCrossRefGoogle Scholar
  139. 139.
    Treasure T, Sedrakyan A (2004) Pleural mesothelioma: little evidence, still time to do trials. Lancet 364(9440):1183–1185PubMedCrossRefGoogle Scholar
  140. 140.
    van Ruth S, Baas P, Zoetmulder FA (2003) Surgical treatment of malignant pleural mesothelioma: a review. Chest 123(2):551–561PubMedCrossRefGoogle Scholar
  141. 141.
    Bolukbas S, Manegold C, Eberlein M, Bergmann T, Fisseler-Eckhoff A, Schirren J (2011) Survival after trimodality therapy for malignant pleural mesothelioma: Radical Pleurectomy, chemotherapy with cisplatin/pemetrexed and radiotherapy. Lung Cancer 71(1):75–81PubMedCrossRefGoogle Scholar
  142. 142.
    Flores RM (2009) Surgical options in malignant pleural mesothelioma: extrapleural pneumonectomy or pleurectomy/decortication. Semin Thorac Cardiovasc Surg 21(2):149–153PubMedCrossRefGoogle Scholar
  143. 143.
    Zauderer MG, Krug LM (2011) The evolution of multimodality therapy for malignant pleural mesothelioma. Curr Treat Options Oncol 12(2):163–172PubMedCrossRefGoogle Scholar
  144. 144.
    Treasure T, Lang-Lazdunski L, Waller D, Bliss JM, Tan C, Entwesle J, Snee M, O’Brien M, Thomas G et al (2011) Extra-pleural pneumonectomy versus no extra-pleural pneumonectomy for patients with malignant pleural mesothelioma: clinical outcomes of the Mesothelioma and Radical Surgery (MARS) randomised feasibility study. Lancet Oncol 2(8):763–772CrossRefGoogle Scholar
  145. 145.
    Flores RM, Pass HI, Seshan VE, Dycoco J, Zakowski M, Carbone M et al (2008) Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: results in 663 patients. J Thorac Cardiovasc Surg 135(3):620–626PubMedCrossRefGoogle Scholar
  146. 146.
    Kaifi JT, Toth JW, Gusani NJ, Kimchi ET, Staveley-O’Carroll KF, Belani CP et al (2012) Multidisciplinary management of malignant pleural effusion. J Surg Oncol 105(7):731–738PubMedCrossRefGoogle Scholar
  147. 147.
    Morel A, Mishra E, Medley L, Rahman NM, Wrightson J, Talbot D et al (2011) Chemotherapy should not be withheld from patients with an indwelling pleural catheter for malignant pleural effusion. Thorax 66(5):448–449PubMedCrossRefGoogle Scholar
  148. 148.
    Gompelmann D, Eberhardt R, Herth FJ (2011) Advanced malignant lung disease: what the specialist can offer. Respiration 82(2):111–123PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Respiratory Medicine, Hull and East Yorkshire Hospitals NHS Trust, Hull York Medical School, Castle Hill HospitalUniversity of HullEast YorkshireUK

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