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Patient-Reported Outcome Measures in Patients with and without Non-Expandable Lung Secondary to Malignant Pleural
Jesper Koefod Petersen1,2, Katrine Fjaellegaard1,2, Daniel Bech Rasmussen1,2
1Respiratory Research Unit PLUZ, Department of Internal and Respiratory Medicine, Zealand University Hospitals, Roskilde and Næstved, 4000 Roskilde, Denmark.
Background:
Malignant pleural effusion (MPE) affects up to 15% of patients with malignancy, and the prevalence is increasing. Non-expandable lung (NEL) complicates MPE in up to 30% of cases. However, it is not known if patients with malignant pleural effusion and NEL are more symptomatic in activities of daily living compared to patients with MPE with expandable lung.
Methods:
This was an observational study on consecutively recruited patients with MPE from our pleural clinic. Before thoracentesis, patients completed patient-reported outcomes on cancer symptoms (ESAS), health-related quality of life (5Q-5D-5L), and dyspnoea scores. Following thoracentesis, patients scored dyspnoea relief and symptoms during thoracentesis. Data on focused lung ultrasound and pleural effusion biochemistry were collected. The non-expandable lung diagnosis was made by pleural experts based on radiological and clinical information.
Results:
We recruited 43 patients, including 12 with NEL (28%). The NEL cohort resembled those from previous studies concerning ultrasonography, pleural fluid biochemistry, and fewer cases with high volume thoracentesis. Patients with and without NEL were comparable concerning baseline demography. The 5Q-5D-5L utility scores were 0.836 (0.691-0.906) and 0.806 (0.409-0.866), respectively, for patients with and without NEL. We observed no between-group differences in symptom burden or health-related quality of life.
Conclusion:
While the presence of NEL affects the clinical management of recurrent MPE, the presence of NEL seems not to affect patients' overall symptom burden in patients with MPE.
Insights
Patients with malignant pleural effusion (MPE) and non-expandable lung (NEL) do not report worse symptoms or quality of life compared to those with expandable lungs. This finding suggests NEL does not significantly impact daily living symptom burden in MPE patients.
Area of Science:
- Pulmonology
- Oncology
- Thoracic Medicine
Background:
- Malignant pleural effusion (MPE) affects up to 15% of cancer patients, with non-expandable lung (NEL) complicating up to 30% of cases.
- The impact of NEL on daily living symptom burden in MPE patients remains unclear.
Purpose of the Study:
- To compare symptom burden and health-related quality of life (HRQoL) in MPE patients with and without NEL.
- To investigate if NEL influences patient-reported outcomes in MPE.
Main Methods:
- Observational study of 43 consecutively recruited MPE patients.
- Collected patient-reported outcomes including ESAS, EQ-5D-5L, and dyspnoea scores before and after thoracentesis.
- Diagnosed NEL based on radiological and clinical information by pleural experts.
Main Results:
- 12 patients (28%) had NEL; demographic and clinical characteristics were comparable between NEL and non-NEL groups.
- No significant differences were observed in EQ-5D-5L utility scores between patients with and without NEL (0.836 vs 0.806).
- Symptom burden and HRQoL were similar in both groups, indicating no increased symptom burden due to NEL.
Conclusions:
- While NEL influences clinical management of recurrent MPE, it does not appear to increase overall symptom burden.
- Patient-reported outcomes regarding daily living activities are not significantly affected by the presence of NEL in MPE patients.
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