Survival difference in patients with malignant pleural effusions treated with pleural catheter or talc pleurodesis

Abstract

Malignant pleural effusions (MPE) are commonly managed with either pleural catheter (PC) or talc pleurodesis (TP). The aim of this study was to compare survival in MPE patients treated with either PC or TP. A retrospective review of our cancer center database was performed. Patients with metastatic cancer and MPE were analyzed. Demographic and clinical data were tabulated and compared. A total of 238 patients with MPE treated by either PC or TP were included. Of these, 79 patients comprised the PC group and 159 the TP group. PC had a higher incidence of advanced disease (stage III or IV) at initial diagnosis compared with TP (70.9% vs 57.2%, P 5 0.05). TP had a longer postprocedure length of stay compared with PC (7.1 vs 5.0 days, P 5 0.02); however, overall length of stay was similar (9.7 vs 11.1 days, P 5 0.34). Readmissions were significantly lower in TP (11.9% vs 22.8%, P 5 0.04). Mean survival was higher in TP compared with PC (18.7 vs 4.1 months, P< 0.001). Patients with metastatic cancer and MPE treated with TP had significantly higher survival compared with PC. This is likely related to a greater disease burden in PC, as 70 per cent of patients in this group had stage III or IV disease on initial presentation.