title: Prognostic factors in patients with malignant pleural effusion: Is it possible to predict mortality in patients with good performance status?
abstract: OBJECTIVE
  The aim of this study was to identify predictors of mortality only in patients with malignant pleural effusion (MPE) showing good performance status which required pleural palliative procedures.
  
  
  METHODS
  All patients with MPE submitted to pleural palliative procedure were enrolled in a prospective study between 2013 and 2014. Patients with Eastern cooperative oncology group (ECOG) score zero, one, and two were considered with good performance status. The possible prognostic factors were tested for significance using the log-rank test (Kaplan-Meier method) and those with significance on univariate analysis were entered into a multivariable Cox model.
  
  
  RESULTS
  A total of 64 patients were included in the analysis. Median follow-up time for surviving patients was 263 days. Median survival for the entire cohort was not reached yet. In the multivariate analysis, gastrointestinal primary site (P = 0.006), low albumin concentration in the pleural fluid (P = 0.017), and high serum NLR (P = 0.007) were associated with mortality.
  
  
  CONCLUSIONS
  In our cohort of ECOG 0-2 patients with MPE submitted to pleural palliative procedures, gastrointestinal malignancy compared to other sites, low pleural fluid albumin and high NLR were significantly associated with mortality. The identification of these prognostic factors may assist the choice of the optimal palliative technique. J. Surg. Oncol. 2016;113:570-574. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Thoracic Surgery of Hospital São José, São Paulo, Brazil.
authors.forename: Fernando Conrado
authors.initials: FC
authors.lastname: Abrao
authors.affiliation: Department of Medical Oncology of Hospital São José, São Paulo, Brazil.
authors.forename: Renata D'Alpino
authors.initials: RD
authors.lastname: Peixoto
authors.affiliation: Department of Thoracic Surgery of Hospital São José, São Paulo, Brazil.
authors.forename: Igor Renato Louro Bruno
authors.initials: IR
authors.lastname: de Abreu
authors.affiliation: Department of Thoracic Surgery of Hospital São José, São Paulo, Brazil.
authors.forename: Maria Cláudia
authors.initials: MC
authors.lastname: Janini
authors.affiliation: Department of Thoracic Surgery of Hospital São José, São Paulo, Brazil.
authors.forename: Geisa Garcia
authors.initials: GG
authors.lastname: Viana
authors.affiliation: Department of Thoracic Surgery of Hospital São José, São Paulo, Brazil.
authors.forename: Mariana Campello
authors.initials: MC
authors.lastname: de Oliveira
authors.affiliation: Department of Thoracic Surgery of Hospital São José, São Paulo, Brazil.
authors.forename: Riad Naim
authors.initials: RN
authors.lastname: Younes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology; D004322:Drainage; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology; D006304:Health Status; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D062072:Patient Acuity; D016066:Pleural Effusion, Malignant / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D018700:Pleurodesis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D055815:Young Adult
keywords: malignant; palliative care; pleura; pleural effusion; survival