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Malignant pleural effusions.

Joe B Putnam1

  • 1Department of Thoracic and Cardiovascular Surgery, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 445 Houston, TX 77030-4095, USA. putnam@mdanderson.org

The Surgical Clinics of North America
|December 11, 2002
PubMed
Summary

Managing recurrent malignant pleural effusions (MPE) requires symptom relief and careful treatment assessment. Chronic indwelling pleural catheters may offer a patient-centered approach, improving quality of life for patients with limited life expectancy.

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Area of Science:

  • Pulmonology
  • Oncology
  • Palliative Care

Background:

  • Recurrent malignant pleural effusions (MPE) are a common clinical challenge.
  • Current treatment strategies for MPE are highly variable and often hospital-centered.
  • Effective management requires balancing treatment benefits against associated risks.

Purpose of the Study:

  • To evaluate optimal management strategies for recurrent malignant pleural effusions.
  • To compare patient-centered outcomes of different MPE treatment modalities.
  • To identify cost-effective and palliative care approaches for MPE.

Main Methods:

  • Review of current literature on pleural effusion and MPE management.
  • Comparative analysis of pleurodesis, indwelling pleural catheters, and thoracostomy.

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  • Assessment of patient-centered outcomes including symptom relief, hospitalization, and cost.

    • Main Results:

    • Pleurodesis is a hospital-centered measure of success.
    • Chronic indwelling pleural catheters may offer a patient-centered approach for palliation, functional optimization, and reduced hospitalization in MPE.
    • Alternative methods like tube thoracostomy and thoracoscopy have variable hospitalization and increased costs.

    Conclusions:

    • Chronic indwelling pleural catheters represent a potentially superior patient-centered management strategy for recurrent malignant pleural effusions.
    • Careful assessment of benefits and risks is crucial for selecting the optimal MPE treatment.
    • Further research into cost-effectiveness of outpatient management for MPE is warranted.