Malignant pleural effusions: appropriate treatment approaches

Malignant pleural effusion (MPE) is a common and important clinical condition. A complication in many types of tumors, its presence indicates the onset of the terminal stages of cancer. Dyspnea is the most common symptom of MPE. The most common underlying tumors are lymphomas and cancers of the lung, breast and ovaries, which account for 75% of cases. The diagnosis of MPE can be established by the presence of malignant cells in the pleural fluid or tissue. Median survival in these patients ranges from 3 to 12 months, with the shortest survival period presenting in lung cancer patients. The aim of MPE therapeutic approaches should be effective treatment and a short hospital stay. There are many different treatment options for patients who suffer from MPE, including serial thoracentesis, tube thoracostomy, pleurodesis, long term pleural catheter, pleuroperitoneal shunt, decortication, chemotherapy and radiotherapy. The choice of therapy is determined based on a patient's clinical situation as well as the underlying disease. Today, intercostal tube insertion and chemical pleurodesis are the most commonly prescribed treatment modalities.