title: Talc pleurodesis improves survival of patients with malignant pleural effusions: case-control study.
abstract: OBJECTIVE
  The aim of this study is to investigate whether there was a considerable difference in the survival of patients with malignant pleural effusion (MPE) depending on the pleural effusion treatment option.
  
  
  METHODS
  One hundred and seven patients with proven MPE (metastatic lung and breast cancer) were included in the retrospective study. Fifty six patients were treated with talc pleurodesis and a control group of 51 patients with similar characteristics (in age, sex and disease) were treated with serial thoracentesis. The patients of both groups underwent chemotherapy and/or radiotherapy. The overall survival and the survival in subgroups of patients with different tumour types and different performance status (PS) equal 1, 2 and 3 were compared.
  
  
  RESULTS
  The patients who underwent talc pleurodesis had a longer average survival interval (MS) than the patients without such a treatment (n = 56; MS = 21,5 and n = 51; MS = 9 weeks, respectively; p < 0.001). The best results were achieved in patients with PS 1 (n = 16; MS = 35.5 and n = 10; MS = 11 weeks in the groups with and without talc pleurodesis, respectively; p < 0,001) and PS 2 (n = 27; MS = 21 and n = 30; MS = 10 weeks in the groups with and without talc pleurodesis, respectively; p < 0.001), whereas talc pleurodesis was not effective in PS 3 patients (n = 13; MS = 10 and n = 11; MS = 7 weeks in the groups with and without talc pleurodesis, respectively; p = 0.08). Patients with the breast cancer showed a longer average survival interval after pleurodesis than those with the lung cancer (n = 12; MS = 37.5 and n =  4; MS = 20 weeks in the group with the breast cancer and with the lung cancer, respectively; p < 0.001), whereas the median survival was not significantly different between those patients without pleurodesis (n = 10; MS = 10 and n = 41; MS = 9 weeks in the group with the breast cancer and lung cancer, respectively; p = 0.11).
  
  
  CONCLUSIONS
  The patients treated with talc pleurodesis had a significantly longer average survival than the patients without such a treatment, especially in the group with the breast cancer and in groups with better performance status. This may indicate that talc pleurodesis, apart from its symptomatic effect on the cessation of pleural effusion, may have a direct antitumour effect as well.
authors: University Hospital for Lung Diseases "Jordanovac", Jordanovac 104, HR-10000, Zagreb, Croatia. mkorsic70@gmail.com.
authors: Marta
authors: M
authors: Korsic
authors: University Hospital for Lung Diseases "Jordanovac", Jordanovac 104, HR-10000, Zagreb, Croatia.
authors: Sonja
authors: S
authors: Badovinac
authors: University Hospital for Lung Diseases "Jordanovac", Jordanovac 104, HR-10000, Zagreb, Croatia.
authors: Branka
authors: B
authors: Cucevic
authors: University Hospital for Lung Diseases "Jordanovac", Jordanovac 104, HR-10000, Zagreb, Croatia.
authors: Zoran
authors: Z
authors: Janevski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000401:mortality* / Q000628:therapy*; D018700:Pleurodesis / Q000379:methods* / Q000401:mortality*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013627:Talc / Q000008:administration & dosage*; D014014:Tissue Adhesives / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D014014:Tissue Adhesives; D013627:Talc
keywords: malignant pleural effusion; pleurodesis; survival