Pleurodesis in follow-up and treatment of malignant pleural mesothelioma patients.
We analyzed the necessity of pleurodesis in the follow-up of the patients with malignant pleural mesothelioma (MPM), and how much it contributes to the survival period by determining the indications, efficiency, and reliability of the pleurodesis application. 191 patients were assessed retrospectively and 69 (36%) of them were established with a pleurodesis indication. In 42 patients accepting pleurodesis, the pleurodesis success was evaluated. Factors affecting the success of pleurodesis and the effect of pleurodesis on survival were assessed. Pleurodesis was a success in 26 (62%) of the 42 patients. In the group in which the pleurodesis process was a success, it was observed that KPS and pleural fluid pH were higher (p= 0.030, p= 0.032, respectively). In case of KPS > or = 80, the sensitivity was: 76.9%, specificity: 50.0%, PPV: 71.4%, and NPV was established as 57.1%. In case of pleural fluid pH > 7.27, the sensitivity was: 92.9%, specificity: 50.0%, PPV: 76.5%, and NPV was observed as 80.0%. In the group in which pleurodesis was a success, the median survival was longer (Log-rank: 11.2; p= 0.0008). Independently from chemotherapy, the chance of living longer for patients whose pleurodesis was a success was 2.6 times higher. A severe complication concerning the process was not observed. Pleurodesis is performed less frequently than it is assumed on patients with MPM. In patients with KPS > or = 80, pleural fluid pH > 7.27, and with indication, pleurodesis must be administered. In feasible patients, a successful pleurodesis with talc increases the survival of patients with MPM, and it can be safely administered.
Ak
Güntülü
G
Department of Chest Diseases, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey. guntuluak@yahoo.com
Metintaş
Muzaffer
M
Yildirim
Hüseyin
H
Metintaş
Selma
S
Dündar
Emine
E
Erginel
Sinan
S
Alataş
Füsun
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000401:mortality / Q000628:therapy*; D018700:Pleurodesis / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013627:Talc / Q000627:therapeutic use; D016896:Treatment Outcome
D013627:Talc