Predictors of talc pleurodesis outcome in patients with malignant pleural effusions.
OBJECTIVE
Chemical pleurodesis is an accepted palliative therapy for patients with recurrent, symptomatic, malignant pleural effusions (MPE). The purpose of the study was to determine the factors that have an effect on successful pleurodesis for MPE.


METHODS
Eighty-four consecutive patients with biopsy-proven malignant pleural disease and recurrent, symptomatic MPE were eligible to participate in this study. Five grams of talc mixed in 150ml of normal saline were administered via tube thoracostomy or small-bore catheters after complete drainage of the pleural effusion.


RESULTS
Seven patients did not return for their 30-day follow-up visit and were excluded from further analysis. Successful pleurodesis was achieved in 63 of 77 eligible patients (81.8%) with MPE. In the univariate analysis, female gender, Karnofsky performance status, pleural fluid pH, cholesterol, and adenosine deaminase level showed a significant association with the probability of success. Multivariate logistic regression analysis showed that pleural fluid pH and ADA levels were independent predictors of talc pleurodesis outcome.


CONCLUSIONS
Our results show that pleurodesis using talc as the sclerosing agent is a simple and acceptable procedure with high efficacy for controlling MPE, especially when used in appropriate patients.
Yildirim
Huseyin
H
Osmangazi University, Medical Faculty, Department of Chest Disease, 26480 Meselik, Eskisehir, Turkey. heylul2002@yahoo.com
Metintas
Muzaffer
M
Ak
Güntülü
G
Metintas
Selma
S
Erginel
Sinan
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D016066:Pleural Effusion, Malignant / Q000737:chemistry / Q000628:therapy*; D018700:Pleurodesis / Q000379:methods; D012372:ROC Curve; D012737:Sex Factors; D013627:Talc / Q000008:administration & dosage*; D016896:Treatment Outcome
D013627:Talc