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Updated: Feb 8, 2026
03:22
Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
Published on: November 10, 2023
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Risk factors for pleural effusion recurrence in patients with malignancy.
Horiana B Grosu1, Sofia Molina1,2, Roberto Casal3
1Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Respirology (Carlton, Vic.)
|July 3, 2018
Summary
Identifying risk factors for malignant pleural effusion recurrence is crucial for effective patient management. Larger effusion size, more fluid drained, and higher LDH levels increase recurrence risk, while negative cytology decreases it.
Area of Science:
- Pulmonology
- Oncology
- Medical Statistics
Background:
- Malignant pleural effusion (MPE) management focuses on symptom palliation.
- Current treatment involves repeat thoracenteses due to unknown recurrence risk factors.
- Identifying these factors is key to improving definitive treatment strategies.
Purpose of the Study:
- To identify risk factors associated with recurrent symptomatic malignant pleural effusion.
- To develop and validate a predictive model for MPE recurrence.
Main Methods:
- Retrospective multicentre cohort study of 988 patients with metastatic disease.
- Cause-specific hazard models and Fine-Gray subdistribution hazard models were used.
- External validation of the predictive model was performed.
Main Results:
- High cumulative incidence of recurrence (30% by day 15).
- Risk factors for recurrence included larger effusion size, greater fluid drained, and higher pleural fluid LDH.
- Negative pleural fluid cytology was associated with decreased recurrence hazard.
Conclusions:
- Pleural effusion size, volume drained, LDH, and cytology are significant risk factors for MPE recurrence.
- The developed predictive model showed low accuracy.
- Further research is needed to refine predictive models for MPE recurrence.
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