title: Outcomes of patients with gynecologic malignancies undergoing video-assisted thoracoscopic surgery (VATS) and pleurodesis for malignant pleural effusion.
abstract: OBJECTIVE
  We evaluated the indications and outcomes of patients with known gynecologic malignancies that underwent video-assisted thoracoscopic surgery (VATS) and pleurodesis for malignant pleural effusion.
  
  
  METHODS
  After IRB approval was obtained, a retrospective study of patients with gynecologic malignancies who underwent planned VATS/pleurodesis between 1/2000 and 7/2010 was performed. Abstracted data included demographics, diagnosis, disease status, treatment history, indication for VATS, complications, and outcomes.
  
  
  RESULTS
  Forty-two patients with a gynecologic malignancy underwent VATS/pleurodesis. Median age was 63 years. Twenty-nine patients (69%) had ovarian cancer. Fifty-seven percent had recurrent disease at the time of VATS and 57% were undergoing chemotherapy at the time of VATS. Eight patients (19%) underwent perioperative VATS to improve pulmonary status. Seven patients (17%) underwent a palliative VATS. The median length of stay was 7 days (range 1-53). Sixty-two percent had gross disease noted at the time of VATS. A mean of 1650 cc of fluid was drained at time of surgery (range 300-4500), and the majority (88%) of patients had a talc pleurodesis performed. Seven patients (17%) were readmitted within 30 days; 6 were for complications unrelated to their VATS. One patient was readmitted with hospital-acquired pneumonia and died during readmission. Median time to death after VATS was 104 days (range 4-1062). Patients who underwent a perioperative VATS had the longest survival (845 days).
  
  
  CONCLUSIONS
  Patients with gynecologic malignancies may require a VATS/pleurodesis for symptomatic pleural effusions. This procedure appears to be safe and effective in this patient population.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, 1700 6th Avenue South, Birmingham, AL 35233, USA. JMW1111@uab.edu
authors.forename: Jenny M
authors.initials: JM
authors.lastname: Whitworth
authors.forename: Kellie E
authors.initials: KE
authors.lastname: Schneider
authors.forename: Janelle M
authors.initials: JM
authors.lastname: Fauci
authors.forename: Ayesha S
authors.initials: AS
authors.lastname: Bryant
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Cerfolio
authors.forename: J Michael
authors.initials: JM
authors.lastname: Straughn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D018700:Pleurodesis / Q000379:methods; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult