Malignant Pleural Effusion at Presentation in Patients with Small-Cell Lung Cancer

Abstract

<b><i>Background:</i></b> Malignant pleural effusion (MPE) is commonly seen in patients with non-small cell lung cancer. However, the prevalence of MPE at presentation in small-cell lung cancer (SCLC) is not reported and the clinical impact of MPE at presentation on patients with SCLC remains largely unknown. <b><i>Objective:</i></b> The objective of this study is to assess the occurrence rate of MPE and its prognostic implications at presentation in patients with SCLC. <b><i>Method:</i></b> We used the Surveillance Epidemiology and End Results (SEER) registry to extract data from patients with SCLC diagnosed between 2004 and 2014. The Kaplan–Meier method was used to estimate the overall survival and the Cox proportional hazard model was used to evaluate whether MPE was an independent risk for outcome. <b><i>Results:</i></b> Among the 68,443 patients with SCLC, MPE was present in 7,639 (11.16%). The probability of MPE was higher in older patients with larger tumors and mediastinal lymph node involvement at presentation. Median overall survival (3 vs. 7 months), estimated 1-year survival (17 vs. 30%), and 2-year survival (6 vs. 14%) were significantly lower in patients with MPE than without MPE, respectively (hazard ratio [HR] 1.46, 95% confidence interval [CI] 1.41–1.50, <i>p</i>< 0.001). MPE was also an independent factor for worse survival in multivariate analysis (HR 1.36, 95% CI 1.32–1.41, <i>p</i> < 0.001). <b><i>Conclusions:</i></b> MPE is common at presentation (11%) in patients with SCLC and may be associated with decreased survival. Additional studies are required to assess the treatment-adjusted survival rate in the setting of MPE.

High Biologically Effective Dose Radiotherapy for Brain Metastases May Improve Survival and Decrease Risk for Local Relapse Among Patients With Small-Cell Lung Cancer: A Propensity-Matching Analysis

“…Although the prognostic effect and mechanism of pleural effusion in patients with BM from SCLC remain largely unknown, 25 our results are consistent with those reported previously. Shojaee et al 26 analyzed data from the Surveillance, Epidemiology, and End Results Program (SEER) and observed that patients with SCLC without pleural effusion had significantly better OS than those with pleural effusion (HR ¼ 1.46, 95% CI: 1.41-1.50, P < .001). Morgensztern et al 27 analyzed patients with NSCLC from the SEER database and determined that the presence of pleural effusion was associated with decreased median OS.…”

The utilization and utility of immunostains in body fluid cytology

“…Malignant effusions may be the presenting feature in 13.5% of patients with pleural effusions, 6% of patients with ascites, and a small minority of patients with pericardial effusions . Malignant pleural effusions in patients with no prior history of malignancy are usually caused by lung cancers, 11% to 16% of which have pleural effusions at presentation . Malignant cells in the ascitic fluid, in patients without a known primary, originate in the ovaries in women and the gastrointestinal tract in men .…”

Effectiveness and Safety of Tunneled Pleural Catheter Placement in Patients with Malignant Pleural Effusions

“…tified as the neoplasm that is associated with more than 30% of cases of malignant PE [2]. Malignant PE is also identified in more than 90% of patients with mesothelioma [12].…”

“…Malignant pleural effusion (PE) is a frequent complication that worsens the quality of life and prognosis of patients with end-stage oncologic disease. Preceded only by parapneumonic PE, malignancy is one of the most common causes of pleural exudates and lung cancer accounts for as much as 37% of these cases [1,2]. In Europe, approximately 100,000 patients with lung cancer develop PE every year and these patients have an average survival of 4 to 7 months [3,4].…”