Annals of Surgical Oncology

, Volume 16, Issue 3, pp 745–750 | Cite as

Bedside Talc Pleurodesis for Malignant Pleural Effusion: Factors Affecting Success

  • Umit Aydogmus
  • Servet Ozdemir
  • Levent Cansever
  • Yasar Sonmezoglu
  • Celalettin Ibrahim Kocaturk
  • Mehmet Ali Bedirhan
Thoracic Oncology

Abstract

Introduction

To determine the factors affecting the success of bedside talc slurry (TS) used for symptomatic treatment of patients with malignant pleural effusion (MPE).

Methods

Data of 113 effusions in 103 MPE patients treated between 1999 and 2007 were retrospectively evaluated for the study. The study group involved 73 patients whose follow-up information was available out of 81 patients treated by TS. Causes of MPE were lung cancer in 22 patients (30.1%) and breast carcinoma in 21 patients (28.8%).

Results

The success rate of TS was significantly higher if the time period between radiological diagnosis of effusion and administration of TS was less than 30 days (P = .02), or spontaneous expansion was attained after chest tube drainage (CTD) (P = .01). Success rate was higher for patients with daily drainage of less than 200 ml before TS than patients with more than 200 ml of daily drainage (P = .01). Dose of talc, either 4 g or above (P = .34), primary cause of MPE (P = .53), time to termination of CTD (P = .57), amount of drainage when CTD was terminated (P = .23), and time period between CTD and administration of TS (P = .20) did not show a statistically significant effect on the success of TS.

Conclusion

In the treatment of malignant pleural effusion, patients with daily drainage of less than 200 ml before TS developed less recurrence than patients with daily drainage of more than 200 ml. Longer time period between the diagnosis of MPE and onset of CTD increased recurrence.

References

  1. 1.
    Tremblay A, Michaud G. Single-center experience with 250 tunnelled pleural catheter insertions for malignant pleural effusion. Chest. 2006;129:362–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Antunes G, Neville E, Duffy J, et al. BTS guidelines for the management of malignant pleural effusions. Thorax. 2003;58(Suppl II):ii29–38.PubMedGoogle Scholar
  3. 3.
    Tan C, Sedrakyan A, Browne J, et al. The evidence on the effectiveness of management for malignant pleural effusion: a systematic review. Eur J Cardiothorac Surg. 2006;29:829–38.PubMedCrossRefGoogle Scholar
  4. 4.
    Kuzniar TJ, Blum MG, Kasibowska-Kuzniar K, et al. Predictors of acute lung injury and severe hypoxemia in patients undergoing operative talc pleurodesis. Ann Thorac Surg. 2006;82:1976–81.PubMedCrossRefGoogle Scholar
  5. 5.
    Cohen RG, Shely WW, Thompson SE, et al. Talc pleurodesis: Talc slurry versus thoracoscopic talc insufflation in a porcine model. Ann Thorac Surg. 1996;62:1000–2.PubMedCrossRefGoogle Scholar
  6. 6.
    Shan SA. Malignant pleural effusions. In: Shields TW, editors. General Thoracic Surgery. 6th ed., vol. 1. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 935–43.Google Scholar
  7. 7.
    Haas RA, Sterman DH, Musani AI. Malignant pleural effusions management options with consideration of coding, billing, and a decision approach. Chest. 2007;132:1036–41.PubMedCrossRefGoogle Scholar
  8. 8.
    Ong KC, Indumathi V, Raghuram J, et al. A comparative study of pleurodesis using talc slurry and bleomycin in the management of malignant pleural effusions. Respirology. 2000;5:99–103.PubMedCrossRefGoogle Scholar
  9. 9.
    Dresler CM, Olak J, Herndon II JE, et al. Phase III intergroup study of talc poudrage versus talc slurry sclerosis for malignant pleural effusions. Chest. 2005;127:909–15.PubMedCrossRefGoogle Scholar
  10. 10.
    DeCampos JR, Vargas FS, DeCampos Werebe E, et al. Thoracoscopy talc poudrage: a 15-year experience. Chest. 2001;119:801–6.CrossRefGoogle Scholar
  11. 11.
    Kennedy L, Rusch VW, Strange C, et al. Pleurodesis using talc slurry. Chest. 1994;106:342–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Stefani A, Natali P, Casali C, et al. Talc poudrage versus talc slurry in the treatment of malignant pleural effusion: a prospective comparative study. Eur J Cardiothorac Surg. 2006;30:827–32.PubMedCrossRefGoogle Scholar
  13. 13.
    Burrows CM, Mathews WC, Colt HG. Predicting survival in patients with recurrent symptomatic malignant pleural effusion: an assessment of the prognostic values of physiologic, morphologic and quality of life measures of extent of disease. Chest. 2000;117:73–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Kolschmann S, Ballin A, Gillissen A. Clinical efficacy and safety of thoracoscopic talc pleurodesis in malignant pleural effusions. Chest. 2005;128:1431–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Warren WH, Kim AW, Liptay MJ. Identification of clinical factors predicting Pleurx® catheter removal in patients treated for malignant pleural effusion. Eur J Cardiothorac Surg. 2008;33:89–94.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2008

Authors and Affiliations

  • Umit Aydogmus
    • 1
  • Servet Ozdemir
    • 1
  • Levent Cansever
    • 1
  • Yasar Sonmezoglu
    • 1
  • Celalettin Ibrahim Kocaturk
    • 1
  • Mehmet Ali Bedirhan
    • 1
  1. 1.Department of Third Thoracic SurgeryYedikule Teaching Hospital for Chest Diseases and Thoracic SurgeryIstanbulTurkey

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