title: A propensity score-matched comparison of the efficacies of OK-432 and talc slurry for pleurodesis for malignant pleural effusion induced by lung adenocarcinoma.
abstract: BACKGROUND
  The choice of an optimal sclerosant for pleurodesis for malignant pleural effusion remains controversial. This retrospective clinical study compared the efficacy and safety of two sclerosants; talc slurry (talc-s) and OK-432.
  
  
  METHODS
  We compared the characteristics, 30/90-day success rates, and adverse events in patients with lung adenocarcinoma who underwent pleurodesis by using either OK-432 or talc-s. Propensity score matching was used to compare the two scelrosants.
  
  
  RESULTS
  Ninety-four patients (mean age=71.6±9.6 years) were included in this retrospective study, of whom 64 received OK-432 and 30 received talc-s. Seventy-three patients (77.6%) were initially diagnosed with clinical stage IV lung cancer, with a 28.7% epidermal growth factor receptor mutation frequency. The propensity score-matched cohort included 26 patients from each group. The 30-day success rates for OK-432 and talc-s were 80.7% and 76.9%, respectively (odds ratio: 1.26, 95% confidence interval: 0.33-4.77, p=0.73). Neither the overall incidence of adverse events nor the 90-day success rates differed significantly. Multivariate logistic regression revealed that the predictors of 30-day success were lower drainage volume on the previous day, particularly <250mL/day, the presence of full lung expansion, and pre-therapy with an epidermal growth factor receptor-tyrosine kinase inhibitor. The median post-pleurodesis survival time was 6.9 months, which was not significantly different between the study groups.
  
  
  CONCLUSIONS
  Propensity score-matched analyses showed that pleurodesis using OK-432 and talc-s demonstrated comparable efficacy and safety profiles in patients with lung adenocarcinoma. This indicated that OK-432 could be a viable alternative to talc-s in this procedure.
authors: Division of Respiratory Medicine, Komaki City Hospital, 1-20 Johbuji, Komaki 485-8520, Japan. Electronic address: kango19841204@outlook.jp.
authors: Kango
authors: K
authors: Nohara
authors: Division of Respiratory Medicine, Komaki City Hospital, 1-20 Johbuji, Komaki 485-8520, Japan. Electronic address: k-takada@komakihp.gr.jp.
authors: Kazuto
authors: K
authors: Takada
authors: Division of Respiratory Medicine, Komaki City Hospital, 1-20 Johbuji, Komaki 485-8520, Japan. Electronic address: e-kojima@komakihp.gr.jp.
authors: Eiji
authors: E
authors: Kojima
authors: Division of Respiratory Medicine, Komaki City Hospital, 1-20 Johbuji, Komaki 485-8520, Japan. Electronic address: nino-kiyo@komakihp.gr.jp.
authors: Kiyoko
authors: K
authors: Ninomiya
authors: Division of Respiratory Medicine, Komaki City Hospital, 1-20 Johbuji, Komaki 485-8520, Japan. Electronic address: shoko.miyamatsu@gmail.com.
authors: Shoko
authors: S
authors: Miyamatsu
authors: Division of Respiratory Medicine, Komaki City Hospital, 1-20 Johbuji, Komaki 485-8520, Japan. Electronic address: shimi-taka@komakihp.gr.jp.
authors: Takahiro
authors: T
authors: Shimizu
authors: Division of Respiratory Medicine, Komaki City Hospital, 1-20 Johbuji, Komaki 485-8520, Japan. Electronic address: tsakura390@gmail.com.
authors: Tsutomu
authors: T
authors: Sakurai
authors: Division of Respiratory Medicine, Komaki City Hospital, 1-20 Johbuji, Komaki 485-8520, Japan. Electronic address: straight.822@gmail.com.
authors: Takaaki
authors: T
authors: Mizuno
authors: Division of Respiratory Medicine, Komaki City Hospital, 1-20 Johbuji, Komaki 485-8520, Japan. Electronic address: a6mb1095@icloud.com.
authors: Yuuki
authors: Y
authors: Yamashita
mesh_terms: D000230:Adenocarcinoma / Q000150:complications*; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications*; D008297:Male; D010844:Picibanil / Q000008:administration & dosage* / Q000627:therapeutic use; D016066:Pleural Effusion, Malignant / Q000628:therapy*; D018700:Pleurodesis / Q000379:methods*; D057216:Propensity Score; D012044:Regression Analysis; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D013627:Talc / Q000008:administration & dosage*
chemical_list: D012597:Sclerosing Solutions; D013627:Talc; D010844:Picibanil
keywords: Lung cancer; OK-432; Pleural effusion; Pleurodesis; Talc