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Survival in Patients With Malignant Pleural Effusions Who Developed Pleural Infection: A Retrospective Case Review

Anna C Bibby1, Amelia O Clive2, Gerry C Slade3

  • 1Royal United Hospital NHS Trust, Combe Park, Bath.

Chest
|November 28, 2014
PubMed
Abstract

Insights

Pleural infection in patients with indwelling pleural catheters (IPCs) for malignant pleural effusion (MPE) may be linked to longer survival, especially for mesothelioma. Further research is needed to confirm this association.

Area of Science:

  • Oncology
  • Pulmonology
  • Infectious Diseases

Background:

  • Malignant pleural effusion (MPE) has a poor prognosis, with increasing incidence.
  • Indwelling pleural catheters (IPCs) are used to manage MPE symptoms but carry a risk of pleural infection.
  • Understanding the outcomes of pleural infection in MPE patients is crucial.

Purpose of the Study:

  • To investigate the survival outcomes of patients who develop pleural infection following IPC insertion for MPE.
  • To compare survival in patients with pleural infection to historical MPE cohorts and national statistics.
  • To explore potential associations between pleural infection and survival, particularly in specific cancer types.

Main Methods:

  • A retrospective review of patients with IPCs for MPE and subsequent pleural infection across six UK centers (2005-2014).
  • Comparison of survival data with a cohort of 788 MPE patients (LENT cohort) and national survival statistics.
  • Analysis of factors influencing survival, including cancer type and timing of infection.

Main Results:

  • Of 672 IPCs, 25 (3.7%) resulted in infection, predominantly in mesothelioma and lung cancer patients.
  • Median survival in the pleural infection cohort (386 days) was longer than the LENT cohort (132 days), though not statistically significant (P=.07).
  • Mesothelioma patients with pleural infection showed significantly longer survival (753 days) compared to national estimates (<365 days) and the LENT cohort (339 days).

Conclusions:

  • Pleural infection in patients with IPCs for MPE may be associated with improved survival, particularly in mesothelioma.
  • The findings suggest a potential role for the immune response to infection in modulating cancer progression.
  • Larger studies are warranted to validate these preliminary findings and explore the underlying mechanisms.

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