Derrame pleural neoplásico

Teixeira, Lisete R.; Pinto, José Antonio de Figueiredto; Marchi, Evaldo

doi:10.1590/s1806-37132006000900004

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…The British Thoracic Society (BTS) used a three-step grading system [5], which was transposed to the four-step grading system used by the other guidelines (BTS grade C becomes D). The Brazilian guideline [6] was not listed since no English version was available.…”

Section: Discussionmentioning

confidence: 99%

Pleural drainage and pleurodesis: implementation of guidelines in four hospitals

Burgers¹,

Kunst²,

Koolen³

et al. 2008

European Respiratory Journal

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The aim of the present study was to evaluate the implementation of the 2003 Dutch guideline on the diagnosis and treatment of malignant pleural effusions, and the potential effect of the implementation on the clinical outcome of pleurodesis.All patients with malignant pleural effusion who had a pleural drain placed with the intention of performing pleurodesis were registered prospectively in four centres. Details of the procedure and fluid recurrence and survival data were noted.Patients with a proven malignancy (n5100) were entered into the registration database. Diagnostic guideline recommendations were followed in 60-70% of the patients. Surprisingly, pleurodesis was performed in only 75% of the patients, mainly due to the presence of a trapped lung. All pleurodeses were performed using talc, according to the guideline. Follow-up revealed fluid recurrence in 27 (36%) patients after a mean follow-up of 17 days (range 2-285 days); 14 patients with successful pleurodesis died with a median survival of 61 days (range 13-174 days). Systemic treatment following pleurodesis and good apposition of the pleural surfaces during drainage were good prognostic factors.Despite reasonable-to-good adherence to the guideline, the number of successful pleurodeses was low. Better predictors of a good pleurodesis outcome are needed.

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Section: Discussionmentioning

confidence: 99%

Pleural drainage and pleurodesis: implementation of guidelines in four hospitals

Burgers¹,

Kunst²,

Koolen³

et al. 2008

European Respiratory Journal

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“…(10,11) Because the lungs are common sites of metastatic disease, (12) the identification of malignant cells in the pleural fluid, together with the results of a biopsy of the parietal pleura, can provide evidence that the primary disease has spread or progressed, and such progression has been associated with decreased life expectancy. (13) Therefore, we stress the importance of identifying organ-specific characteristics of metastatic breast cancer, because such data can further the understanding of the natural history of the disease. (5,14) The objective of this study was to identify the clinical and pathological factors that affect the survival of patients with a history of breast 489 pleural effusion, the mean age at death was 57.8 ± 12.0 years.…”

Section: Introductionmentioning

confidence: 99%

Fatores clínicos e anatomopatológicos que influenciam a sobrevida de pacientes com câncer de mama e derrame pleural neoplásico

et al. 2012

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Objective: The objective of this study was to identify the clinical and pathological factors that can influence the prognosis of breast cancer patients with clinical symptoms of malignant pleural effusion. Methods: This was a clinical cohort study, in which we analyzed the medical charts of patients diagnosed with malignant pleural effusion between 2006 and 2010. By examining the charts, we identified the female patients with a history of breast cancer. For those patients, we collected pathology data related to the primary tumor and cytopathology data related to the pleural metastasis. Results: We evaluated 145 patients, 87 (60%) of whom had tested positive for malignant cells in the pleural fluid. Ductal histology was observed in 119 (82%). The triple-negative breast cancer phenotype was seen in 25 cases (17%). Those patients had the worst prognosis (with a sharp decline in the survival curve), and 20 of the 25 (80%) died during the follow-up period (through June of 2011). The mean survival after the identification of malignant pleural effusion was 6 months. Conclusions: In patients with triple-negative breast cancer who test positive for malignant cells in the pleural fluid, the prognosis is poor and survival is reduced.Keywords: Pleural effusion, malignant/mortality; Breast neoplasms/mortality; Breast neoplasms/genetics. ResumoObjetivo: O objetivo deste estudo foi identificar os fatores clínicos e anatomopatológicos que possam influenciar o prognóstico de pacientes com câncer de mama e sintomas clínicos de derrame pleural neoplásico. Métodos: Trata-se de um estudo clínico de coorte, no qual foram analisados os prontuários médicos de pacientes que receberam diagnóstico de derrame pleural neoplásico entre 2006 e 2010. Por meio da análise dos prontuários, identificamos as pacientes com história de câncer de mama. Para essas pacientes, coletamos dados anatomopatológicos relacionados ao tumor primário e dados citopatológicos relacionados à metástase pleural. Resultados: Das 145 pacientes avaliadas, 87 (60%) apresentaram, no exame citológico, resultado positivo para células neoplásicas no líquido pleural; além disso, 119 (82%) apresentaram tipo histológico ductal. O fenótipo triplo-negativo foi observado em 25 pacientes (17%), as quais apresentaram o pior prognóstico, com queda acentuada na curva de sobrevida. Das 25 pacientes, 20 (80%) evoluíram a óbito durante o período de seguimento (até junho de 2011). A sobrevida média após a identificação de derrame pleural neoplásico foi de 6 meses. Conclusões: Em pacientes com câncer de mama triplo-negativo e exame citológico com resultado positivo para células neoplásicas no líquido pleural, o prognóstico é ruim e a sobrevida é menor. cancer who develop pleural effusion. To that end, we evaluated factors related to the diagnosis, the histological type of the primary tumor, the identification of malignant cells in the pleural fluid, the expression of immunohistochemical markers of breast cancer, and outcomes. MethodsThis was a hospital-based, historical cohort study...

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“…Identification of malignant cells in pleural fluid suggests primary disease spread and progression, which leads to a reduced life expectancy of cancer patients [17,18,19]. However, since there are differences on survival time between some groups of patients [20,21,22], identifying the characteristics of each organ-specific metastatic breast cancer may play a major role in understanding this malignancy [1,23,24].…”

Section: Introductionmentioning

confidence: 99%

Impact of Cell Arrangement of Pleural Effusion in Survival of Patients with Breast Cancer

et al. 2014

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Objective: This study was performed to evaluate the potential influence of cytological differences between pleural effusions on the survival of women with metastatic breast cancer during 30 months of follow-up. Study Design: A hospital-based cohort study was performed. Pleural fluid cytology slides from patients with breast cancer were examined. Cases were grouped according to the pattern of tumor cells (spheroid and isolated), in order to access their prognostic value. Results: The study comprised 87 patients. An isolated cell pattern was associated with higher mortality 30 months after the pleural effusion when compared to a spheroid pattern (p = 0.038). Patients with an isolated cell pattern showed higher risk of dying than patients with spheroid formations. The relative risk after adjustment of intervening variables was 5.336 (95% CI 1.054-27.020). The presence of a triple-negative immunohistochemical pattern significantly increased the risk of mortality before 30 months. Conclusion: Pleural effusion with isolated malignant cells is associated with worse prognosis after 30 months of follow-up.

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Derrame pleural neoplásico

Cited by 6 publications

References 21 publications

Pleural drainage and pleurodesis: implementation of guidelines in four hospitals

Pleural drainage and pleurodesis: implementation of guidelines in four hospitals

Fatores clínicos e anatomopatológicos que influenciam a sobrevida de pacientes com câncer de mama e derrame pleural neoplásico

Impact of Cell Arrangement of Pleural Effusion in Survival of Patients with Breast Cancer

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