title: Predictors of survival in patients who underwent video-assisted thoracic surgery talc pleurodesis for malignant pleural effusion.
abstract: BACKGROUND
  Patients with malignant pleural effusion have a limited life expectancy. An increase in pleural and oncological treatment options and more accurate prognostic evaluation may help individualize treatment strategies. The aim of this study was to identify the prognostic indicators of overall survival (OS) after video-assisted thoracic surgery (VATS) talc pleurodesis for malignant pleural effusion.
  
  
  METHODS
  We examined the medical records of all consecutive patients with malignant pleural effusion who underwent VATS talc pleurodesis from 2006 to 2008 at the Samsung Medical Center. Univariate and multivariate analyses were used to identify predictors of OS after VATS talc pleurodesis.
  
  
  RESULTS
  During the study period, 91 patients underwent VATS talc pleurodesis to treat malignant pleural effusion. Early (within 30 days) and late (within 90 days) postoperative mortality rates were 9.9% (9 patients), and 25.3% (23), respectively. Median survival time after VATS talc pleurodesis was 10.5 months. The postoperative respiratory complication rate was 11% (10 patients), and included pneumonia (9) and acute respiratory distress syndrome (4). Multivariate analysis revealed that preoperative chemotherapy (P = 0.012), preoperative radiotherapy (P = 0.003), and Eastern Cooperative Oncology Group (ECOG) performance score 3 or 4 (P = 0.013) were independent risk factors of OS after VATS talc pleurodesis.
  
  
  CONCLUSIONS
  We identified previous chemotherapy or radiotherapy and poor performance status (ECOG 3 or 4) as significant predictors of OS after VATS talc pleurodesis. These prognostic factors can help surgeons select candidates for VATS pleurodesis for malignant pleural effusion.
authors.affiliation: Department of Thoracic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea.
authors.forename: Dong Woog
authors.initials: DW
authors.lastname: Yoon
authors.affiliation: Department of Thoracic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea.
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Cho
authors.affiliation: Department of Thoracic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea.
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Thoracic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea.
authors.forename: Jhingook
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Thoracic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea.
authors.forename: Hong Kwan
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Thoracic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea.
authors.forename: Jae Ill
authors.initials: JI
authors.lastname: Zo
authors.affiliation: Department of Thoracic Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea.
authors.forename: Young Mog
authors.initials: YM
authors.lastname: Shim
keywords: Malignant; pleural effusion; pleurodesis; talc; video‐assisted surgery