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Talc pleurodesis improves survival of patients with malignant pleural effusions: case-control study

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Summary

Aim

The aim of this study is to investigate whether there was a considerable difference in the survival of patients with malignant pleural effusion (MPE) depending on the pleural effusion treatment option.

Methods

One hundred and seven patients with proven MPE (metastatic lung and breast cancer) were included in the retrospective study. Fifty six patients were treated with talc pleurodesis and a control group of 51 patients with similar characteristics (in age, sex and disease) were treated with serial thoracentesis. The patients of both groups underwent chemotherapy and/or radiotherapy. The overall survival and the survival in subgroups of patients with different tumour types and different performance status (PS) equal 1, 2 and 3 were compared.

Results

The patients who underwent talc pleurodesis had a longer average survival interval (MS) than the patients without such a treatment (n = 56; MS = 21,5 and n = 51; MS = 9 weeks, respectively; p < 0.001). The best results were achieved in patients with PS 1 (n = 16; MS = 35.5 and n = 10; MS = 11 weeks in the groups with and without talc pleurodesis, respectively; p < 0,001) and PS 2 (n = 27; MS = 21 and n = 30; MS = 10 weeks in the groups with and without talc pleurodesis, respectively; p < 0.001), whereas talc pleurodesis was not effective in PS 3 patients (n = 13; MS = 10 and n = 11; MS = 7 weeks in the groups with and without talc pleurodesis, respectively; p = 0.08). Patients with the breast cancer showed a longer average survival interval after pleurodesis than those with the lung cancer (n = 12; MS = 37.5 and n = 44; MS = 20 weeks in the group with the breast cancer and with the lung cancer, respectively; p < 0.001), whereas the median survival was not significantly different between those patients without pleurodesis (n = 10; MS = 10 and n = 41; MS = 9 weeks in the group with the breast cancer and lung cancer, respectively; p = 0.11).

Conclusion

The patients treated with talc pleurodesis had a significantly longer average survival than the patients without such a treatment, especially in the group with the breast cancer and in groups with better performance status. This may indicate that talc pleurodesis, apart from its symptomatic effect on the cessation of pleural effusion, may have a direct antitumour effect as well.

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References

  1. Yim APC, Chan ATC, Lee TW, Wan IYP, Ho JKS. Thoracoscopic talc insufflation versus talc slurry for symptomatic malignant pleural effusion. Ann Thorac Surg. 1996;62:1655–8.

    Article  CAS  PubMed  Google Scholar 

  2. Rodrigez-Panadero F, Antony VB. Pleurodesis: state of the art. Eur Respir J. 1997;10:1648–54.

    Article  Google Scholar 

  3. Bethune N. A new technique for the deliberate production of pleural adhesions as a preliminary to lobectomy. J Thorac Surg 1935;4:251–61.

    Google Scholar 

  4. Rodriguez-Panadero F, Montes-Worboys A. Mechanism of Pleurodesis. Respiration. 2012;83(2):91–8. doi:10.1159/000335419. Epub 2012 Jan 20. Review.

    Article  PubMed  Google Scholar 

  5. Kennedy L, Harley RA, Sahn SA, Strange C. Talc slurry pleurodesis. Pleural fluid and histological analysis. Chest. 1995;107(6):1707–12.

    Article  CAS  PubMed  Google Scholar 

  6. Krismann M, Pieper K, Muller KM. Pleural reaction pattern after talc pleurodesis. Pathology. 1998;19(3):214–20.

    Article  CAS  Google Scholar 

  7. Schwarz Y, Star A. Role of talc modulation on cytokine activation in cancer patients undergoing pleurodesis. Pulm Med. 2012;2012:806183. doi:10.1155/2012/806183. Epub 2012 Mar 7.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Viallat JR, Rey F, Astoul P, Boutin C. Thoracoscopic talk poudrage. Pleurodesis for malignant pleural effusions—a review of 360 cases. Chest. 1996;110:1387–93.

    Article  CAS  PubMed  Google Scholar 

  9. Sanchez-Armengol A, Rodrigez-Panadero F. Survival and talc pleurodesis in metastatic pleural carcinoma, revisited. Report of 125 cases. Chest. 1993;104:1482–5.

    Article  CAS  PubMed  Google Scholar 

  10. Martinez-Miragon E, Aparicio J, Sanchis J, Menendez R, Cruz M, Sanchis F. Malignant pleural effusion: prognostic factors for survival and response to chemical pleurodesis in a series of 120 cases. Respiration. 1998;65:108–13.

    Article  Google Scholar 

  11. Burrows CM, Mathews WC, Colt HG. 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. 2000;117:73–8.

    Article  CAS  PubMed  Google Scholar 

  12. de Campos JR, Vargas FS, de Capmos Werebe E, et al. Thoracoscopy talc poudrage: a 15-year experience. Chest. 2001;119:801–6.

    Article  PubMed  Google Scholar 

  13. Nasreen N, Mouhammed KA, Dowling PA, et al. Talc induces apoptosis in human malignant mesothelioma cells in vitro. Am J Respir Crit Care Med. 2000;161:595–600.

    Article  CAS  PubMed  Google Scholar 

  14. Najmunisa N, Mohamed KA, Brown S, Su J, Sriram PS, Moudgil B, Loddenkemper R, Antony VB. Talc mediates angiostasis in malignant pleural effusions via endostatin induction. Eur Respir J. 2007;29:761–9.

    Article  Google Scholar 

  15. Šamija M i suradnici. Onkologija. Zagreb: Medicinska naklada; 2000.

    Google Scholar 

  16. Kaplan ZL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–81.

    Article  Google Scholar 

  17. Molengraft van de FJJM, Vooijs GP. Survival of petients with malignancy-associated effusions. Acta Cytol. 1989;33:911–6.

    PubMed  Google Scholar 

  18. Tan C, Sedrakyan A, Browne J, Swift S, Treasure T. The evidence on the effectivness of management for malignant pleural effusion: a systemic review. Eur J Cardiothorac Surg. 2006;29:829–38.

    Article  PubMed  Google Scholar 

  19. Shaw P, Agarwal R. Pleurodesis for malignant pleural effusions. Cochrane Datebase Sys Rev. 2004;(1):CD002916.

  20. Steger V, Mika U, Toomes H, Walker T, Engel C, Kyriss T, et al. Who gains most?A 10-year experience with 611 thoracoscopic talc pleurodesis. Ann Thorac Surg. 2007;83:1940–5.

    Article  PubMed  Google Scholar 

  21. Viallat JR, Boutin C. Malignant pleural effusions: recourse to early use of talc. Rev Med Interne. 1998;19:811–8.

    Article  CAS  PubMed  Google Scholar 

  22. Genofre EH, Marchi E, Vargas FS. Inflammation and clinical repercussions of pleurodesis induced by intrapleural talk administration. Clinics (Sao Paulo). 2007;62:627.

    Article  Google Scholar 

  23. Lee P, Sun L, Lim CK, Aw SE Selective apoptosis of lung cancer cells with talc. Eur Respir J. 2010;35(2):450–2. doi:10.1183/09031936.00113109.

    Article  CAS  PubMed  Google Scholar 

  24. Kolschmann S, Ballin A, Gillissen A. Clinical efficacy and safety of thoracoscopic talc pleurodesis in malignant pleural effusions. Chest. 2005;128:1431–5.

    Article  PubMed  Google Scholar 

  25. Naito T, Saoth H, Ishikawa H, et al. Pleural effusion as a significant prognostic factor in non-small cell lung cancer. Anticancer Respir. 1997;17:4743–6.

    CAS  Google Scholar 

  26. Love D, White D, Kiroff G. Thoracoscopic talc pleurodesis for malignant pleural effusion. ANZ J Surg. 2003;73:19–22.

    Article  PubMed  Google Scholar 

  27. Hirata T, Yonemori K, Hirakawa A, Shmizu C, TamuraK, Ando M, Katsumata N, Tanimoto M, Fujiwara Y. Efficacy of pleurodesis for malignant pleural effusions in brest cancer patients. Eur Respir J. 2011;38(6):1425–30. doi:10.1183/09031936.00171610. Epub 2011 May 12.

    Article  CAS  PubMed  Google Scholar 

  28. Radić I, Vučak I, Milošević J, Maršić A, Vukičević S, Marušić M. Immunosuppression induced by talc granulomatosis in the rat. Clin Exp Immunol. 1988;73:316–21.

    PubMed Central  PubMed  Google Scholar 

  29. Singer JJ, Jones JC, Tragerman LJ, et al. Aseptic pleuritis experimentally produced. J Thorac Surg. 1941;10:151–83.

    Google Scholar 

  30. Malthlouthi A, Chabchoub A, Labbene N, et al. Etude anatomopathologique experimetale du talcage pleural. Rev Mal Respir. 1992;9:617–21.

    Google Scholar 

  31. Van den Heuvel MM, Smit HJ, Barbierato SB, Havenith CE, Beelen Postmus PE. Talc-induced inflammation in pleural cavity. Eur Respir J. 1998;12(6):1419–23.

    Article  PubMed  Google Scholar 

  32. Nasreen N, Hartman LD, Mohamed KA, Antony VB. Talc-induced expression of C-C and C-X-C chemokines and intercellular adhesion molecule-1 in mesothelial cells. Am J Respir Crit Care Med. 1998;156:971–78.

    Article  Google Scholar 

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Conflict of interest

M. Korsic, S. Badovinac, B. Cucevic, Z. Janevski declare that there are no actual or potential conflicts of interest in relation to this article.

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Authors and Affiliations

  1. University Hospital for Lung Diseases “Jordanovac”, Jordanovac 104, HR-10000, Zagreb, Croatia

    Marta Korsic MD, Sonja Badovinac, Branka Cucevic & Zoran Janevski

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  1. Marta Korsic MD
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  2. Sonja Badovinac
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Correspondence to Marta Korsic MD.

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Korsic, M., Badovinac, S., Cucevic, B. et al. Talc pleurodesis improves survival of patients with malignant pleural effusions: case-control study. Wien Klin Wochenschr 127, 963–969 (2015). https://doi.org/10.1007/s00508-015-0716-8

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