title: Medical talc pleurodesis: which patient with cancer benefits least?
abstract: OBJECTIVE
  Successful talc pleurodesis (TP) for malignant pleural effusion (MPE) gives symptom relief, but may be too exhaustive in cases with poor performance status. The selection of eligible patients is therefore a challenging task. The study was undertaken to evaluate frequency of successful TPs, side effects, complications, performance status, hospitalization time, remaining time alive, and the responsible physician's prediction of a successful TP judged by radiologic findings prior to TP.
  
  
  METHODS
  Side effects of TPs performed during a 1-year period were consecutively recorded and the TP outcomes were retrospectively evaluated 6 years later.
  
  
  RESULTS
  TP success rate was 56% and 79% among best support of care subjects (BSC; n=10) and subjects eligible for cancer therapy (non-BSC; n=19), respectively, while side effects did not differ. Performance status was poorer and survival shorter among BSC subjects. Time spent in hospital of the remaining time alive for BSC and non-BSC subjects was 42%±27% and 4%±4%, respectively. Poor performance status of subjects with lung cancer correlated with short survival time, which in turn correlated with many days at hospital for TP. The physician's prediction of a successful TP was correct in 50% of all cases.
  
  
  CONCLUSIONS
  Performance status of BSC subjects are probably too poor for TP and these subjects have to spend too much time at hospital during the procedure. The responsible physician is able to correctly predict a successful TP outcome in only every second case, supporting the need of additional predictive analysis.
authors.affiliation: Division of Pulmonary Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University , Department of Respiratory Medicine UHL, Centre of Surgery and Oncology, County Council of Östergötland, Linköping, Sweden .
authors.forename: Aldona
authors.initials: A
authors.lastname: Wajda
authors.forename: Helena
authors.initials: H
authors.lastname: Engström
authors.forename: H Lennart
authors.initials: HL
authors.lastname: Persson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000379:methods; D016066:Pleural Effusion, Malignant / Q000628:therapy*; D018700:Pleurodesis; D012189:Retrospective Studies; D016019:Survival Analysis; D013627:Talc / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D013627:Talc