← Back to Search
Management Of Malignant Pleural Effusions-What Is New.
Rajesh Thomas, B. Roy, F. Maldonado, Y. Lee
Published 2019 · Medicine
Download PDFAnalyze on Scholarcy
Malignant pleural effusion (MPE) is a common and challenging problem. Patients affected by MPE have a poor prognosis and suffer from breathlessness and impaired quality of life. The management of MPE has barely changed for many decades; however, recent research has driven new paradigms in the diagnosis and treatment of MPE and stimulated novel concepts that are being evaluated in many ongoing studies. This review provides an overview of recent advances in the diagnosis of MPE, including new cytopathology and imaging techniques, and the landmark studies that provide a solid evidence base to support the use of indwelling pleural catheters as first-line treatment in MPE. Lingering management dilemmas, including optimal chest drainage tube and role of surgery in MPE, and key knowledge gaps that are the focus of ongoing research are also highlighted.
This paper references
Complications of indwelling pleural catheter use and their management
M. M. S. Lui (2016)
Procedures Performed during Hospitalizations for Malignant Pleural Effusions: Data from the 2012 National Inpatient Sample
M. Fortin (2018)
Treatment of malignant pleural effusion: a cost-effectiveness analysis.
V. Puri (2012)
Use of a drug eluting pleural catheter for pleurodesis
A. Tremblay (2012)
Malignant pleural effusion in the presence of trapped lung. Five-year experience of PleurX tunnelled catheters.
C. Efthymiou (2009)
Pleuroscopic Pleurodesis Combined With Tunneled Pleural Catheter for Management of Malignant Pleural Effusion: A Prospective Observational Study
Z. Boujaoude (2015)
CT in differential diagnosis of diffuse pleural disease.
A. Leung (1990)
Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial.
H. E. Davies (2012)
Quality-adjusted survival following treatment of malignant pleural effusions with indwelling pleural catheters.
D. Ost (2014)
Fractured indwelling pleural catheters.
E. Fysh (2012)
A randomized controlled trial comparing indwelling pleural catheters with talc pleurodesis (NVALT-14).
R. Boshuizen (2017)
Single-center experience with 250 tunnelled pleural catheter insertions for malignant pleural effusion.
A. Tremblay (2006)
A randomized comparison of indwelling pleural catheter and doxycycline pleurodesis in the management of malignant pleural effusions
J. Putnam (1999)
Frequent inactivation of the BAP1 gene in epithelioid‐type malignant mesothelioma
Yoshie Yoshikawa (2012)
Intrapleural use of tissue plasminogen activator and DNase in pleural infection.
Najib M. Rahman (2011)
Multidetector CT imaging of pleura: comparison of two contrast infusion protocols.
V. Raj (2011)
Treatment of malignant pleural effusion: pleurodesis using a small percutaneous catheter. A prospective randomized study.
P. Clementsen (1998)
The incidence of pleural effusion in a well-defined region. Epidemiologic study in central Bohemia.
M. Marel (1993)
Pleural Cryobiopsy versus Flexible Forceps Biopsy in Subjects with Undiagnosed Exudative Pleural Effusions Undergoing Semirigid Thoracoscopy: A Crossover Randomized Trial (COFFEE Trial)
S. Dhooria (2019)
Randomized Controlled Trial of Urokinase versus Placebo for Nondraining Malignant Pleural Effusion
Eleanor K. Mishra (2018)
Management of malignant pleural effusions using the Pleur(x) catheter.
W. Warren (2008)
Effect of Opioids vs NSAIDs and Larger vs Smaller Chest Tube Size on Pain Control and Pleurodesis Efficacy Among Patients With Malignant Pleural Effusion: The TIME1 Randomized Clinical Trial.
N. Rahman (2015)
Clinical Characteristics of Patients with Malignant Pleural Mesothelioma Harboring Somatic BAP1 Mutations
M. Zauderer (2013)
Thoracic ultrasound in the diagnosis of malignant pleural effusion
N. R. Qureshi (2008)
A Randomized Trial Comparing the Diagnostic Yield of Rigid and Semirigid Thoracoscopy in Undiagnosed Pleural Effusions
S. Dhooria (2014)
Effect of an Indwelling Pleural Catheter vs Talc Pleurodesis on Hospitalization Days in Patients With Malignant Pleural Effusion: The AMPLE Randomized Clinical Trial
Rajesh Thomas (2017)
Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010
M. Roberts (2010)
Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score
A. Clive (2014)
Comparing cost of indwelling pleural catheter vs talc pleurodesis for malignant pleural effusion.
E. Penz (2014)
Thoracoscopy for the diagnosis of pleural disease.
R. Menzies (1991)
Predictors of clinical use of pleurodesis and/or indwelling pleural catheter therapy for malignant pleural effusion.
E. Fysh (2015)
Pleural fluid pH as a predictor of pleurodesis failure: analysis of primary data.
J. Heffner (2000)
Extrapleural Pneumonectomy in the Treatment of Epithelioid Malignant Pleural Mesothelioma: Novel Prognostic Implications of Combined N1 and N2 Nodal Involvement Based on Experience in 529 Patients
D. Sugarbaker (2014)
Air in the Pleural Cavity Enhances Detection of Pleural Abnormalities by CT Scan.
E. Fysh (2018)
The nuclear deubiquitinase BAP1 is commonly inactivated by somatic mutations and 3p21.1 losses in malignant pleural mesothelioma
Matthew J Bott (2011)
Randomised controlled trial to compare the diagnostic yield of positron emission tomography CT (PET-CT) TARGETed pleural biopsy versus CT-guided pleural biopsy in suspected pleural malignancy (TARGET trial)
D. de Fonseka (2018)
Pleurodesis outcome in malignant pleural mesothelioma
E. Fysh (2013)
Nonspecific pleuritis: optimal duration of follow-up.
Z. Depew (2014)
[Management of malignant pleural effusions].
R. Loddenkemper (2005)
Pleural metastatic tumours and effusions. Frequency and pathogenic mechanisms in a post-mortem series.
F. Rodríguez-Panadero (1989)
Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology
A. Hjerpe (2015)
Catheter tract metastasis associated with indwelling pleural catheters.
Rajesh Thomas (2014)
Use of small-bore vs large-bore chest tubes for treatment of malignant pleural effusions.
W. Parulekar (2001)
The Use of Indwelling Pleural Catheters for the Management of Malignant Pleural Effusion - Direct Costs in a Dutch Hospital
R. Boshuizen (2013)
Efficacy and cost of video-assisted thoracoscopic partial pleurectomy versus talc pleurodesis in patients with malignant pleural mesothelioma (MesoVATS): an open-label, randomised, controlled trial
R. Rintoul (2014)
Physiology of breathlessness associated with pleural effusions
Rajesh Thomas (2015)
Can CT and MR Shape and Textural Features Differentiate Benign Versus Malignant Pleural Lesions?
Elena Peña (2017)
EARLY PLEURODESIS VIA INDWELLIMG PLEURAL CATHETER WITH TALC FOR MALIGNANT EFFUSIONS: THE EPITOME STUDY
S. Muruganandan (2017)
Thoracoscopy in the diagnosis and management of recurrent pleural effusions.
J. Hucker (1991)
Pre-EDIT: protocol for a randomised feasibility trial of elastance-directed intrapleural catheter or talc pleurodesis (EDIT) in malignant pleural effusion
Geoffrey A Martin (2018)
Clinical outcomes of indwelling pleural catheter-related pleural infections: an international multicenter study.
E. Fysh (2013)
Image-guided pleural biopsy
N. Rahman (2008)
Diagnosis of pleural effusions. Experience with clinical studies, 1986 to 1990.
M. Marel (1995)
Pleuroscopic cryoprobe biopsies of the pleura: A feasibility and safety study
Rajesh Thomas (2015)
A diagnosis of malignant pleural mesothelioma can be made by effusion cytology: results of a 20 year audit
A. Segal (2013)
Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion.
C. Dresler (2005)
Whole-exome sequencing reveals frequent genetic alterations in BAP1, NF2, CDKN2A, and CUL1 in malignant pleural mesothelioma.
Guangwu Guo (2015)
BAP1 mutation is a frequent somatic event in peritoneal malignant mesothelioma
H. Alakus (2015)
Malignant pleural disease: diagnosis by using diffusion-weighted and dynamic contrast-enhanced MR imaging--initial experience.
J. Coolen (2012)
Diagnostic value of radiological imaging pre‐ and post‐drainage of pleural effusions
J. Corcoran (2016)
The palliative treatment with intrapleural streptokinase in patients with multiloculated malignant pleural effusion: a double-blind, placebo-controlled, randomized study
Ozkan Saydam (2015)
Use of tunnelled catheters for malignant pleural effusions in patients fit for pleurodesis
A. Tremblay (2007)
Optimal chest drain size: the rise of the small-bore pleural catheter.
E. Fysh (2010)
OPTIMUM: a protocol for a multicentre randomised controlled trial comparing Out Patient Talc slurry via Indwelling pleural catheter for Malignant pleural effusion vs Usual inpatient Management
P. Sivakumar (2016)
Malignant Pleural Mesothelioma: an Update for Pulmonologists
C. Sidhu (2019)
Streptokinase for malignant pleural effusions: a randomized controlled study
E. Okur (2011)
Rapid pleurodesis for malignant pleural effusions: a pilot study.
C. Reddy (2011)
Histopathology of removed indwelling pleural catheters from patients with malignant pleural diseases
Claire L. Tobin (2016)
Treatment of malignant pleural effusion: PleuRx catheter or talc pleurodesis? A cost-effectiveness analysis.
Aaron M Olden (2010)
Spontaneous pneumothorax: time to rethink management?
O. Bintcliffe (2015)
ERS/EACTS statement on the management of malignant pleural effusions
A. Bibby (2019)
Guidelines for the diagnosis and treatment of malignant pleural mesothelioma.
N. van Zandwijk (2013)
Indwelling pleural catheters reduce inpatient days over pleurodesis for malignant pleural effusion.
E. Fysh (2012)
A Novel Drug-Eluting Indwelling Pleural Catheter for the Management of Malignant Effusions.
R. Bhatnagar (2018)
High Incidence of Somatic BAP1 Alterations in Sporadic Malignant Mesothelioma
Masaki Nasu (2015)
Derivation and validation of a CT scan scoring system for discriminating malignant from benign pleural effusions.
J. M. Porcel (2015)
Randomized Trial of Pleural Fluid Drainage Frequency in Patients with Malignant Pleural Effusions. The ASAP Trial
M. Wahidi (2017)
A New Method for Performing Continuous Manometry during Pleural Effusion Drainage
M. Salamonsen (2014)
Management of Malignant Pleural Effusion Associated with Trapped Lung Syndrome
R. Qureshi (2008)
Talc pleurodesis through indwelling pleural catheters for malignant pleural effusions: retrospective case series of a novel clinical pathway.
L. Ahmed (2014)
Interventional therapies for malignant pleural effusions: The present and the future
Rajesh Thomas (2014)
Clinical features and survival of lung cancer patients with pleural effusions
J. M. Porcel (2015)
Aggressive versus symptom-guided drainage of malignant pleural effusion via indwelling pleural catheters (AMPLE-2): an open-label randomised trial.
S. Muruganandan (2018)
Chemotherapy should not be withheld from patients with an indwelling pleural catheter for malignant pleural effusion
A. Morel (2010)
Efficacy and Safety of Tunneled Pleural Catheters in Adults with Malignant Pleural Effusions: A Systematic Review
Margaret E. M. Van Meter (2010)
Routine monitoring with pleural manometry during therapeutic large-volume thoracentesis to prevent pleural-pressure-related complications: a multicentre, single-blind randomised controlled trial.
Robert J Lentz (2019)
Pleurodesis for malignant pleural effusions: current controversies and variations in practices
S. West (2004)
Accuracy of fluorodeoxyglucose-PET imaging for differentiating benign from malignant pleural effusions: a meta-analysis.
J. M. Porcel (2015)
Protocol of the PLeural Effusion And Symptom Evaluation (PLEASE) study on the pathophysiology of breathlessness in patients with symptomatic pleural effusions
Rajesh Thomas (2016)
Analysis of tube thoracostomy performed by pulmonologists at a teaching hospital.
N. Collop (1997)
A Quality Improvement Intervention to Reduce Indwelling Tunneled Pleural Catheter Infection Rates.
Christopher R Gilbert (2015)
Infections Associated With Tunnelled Indwelling Pleural Catheters in Patients Undergoing Chemotherapy
E. Mekhaiel (2013)
Management of Malignant Pleural Effusions. An Official ATS/STS/STR Clinical Practice Guideline
D. Feller-Kopman (2018)
Intrapleural Fibrinolysis for the Treatment of Indwelling Pleural Catheter-Related Symptomatic Loculations: A Multicenter Observational Study.
Rajesh Thomas (2015)
Small bore catheter drainage and sclerotherapy for malignant pleural effusions
L. A. Parker (1989)