Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010

CEA, AFP, CA125, CA153 and CA199 in Malignant Pleural Effusions Predict the Cause

“…Second, the main reason to determine the cause of MPE is to decide whether systemic chemotherapy is indicated. Systemic chemotherapy is effective at least in MPE patients with small cell carcinoma, breast carcinoma or lymphoma (Roberts et al, 2010). For differentiating causes of MPEs, especially CUP, light microscopy, immunocytochemistry, molecular profiling, endoscopy, and imaging have been evaluated by others, limitations of these common techniques are high cost, low sensitivity and selective application.…”

“…Lymphomas, tumors of the genitourinary tract and gastrointestinal tract account for a further 25%. Causes of unknown primary (CUP) are responsible for 7-15% of all malignant pleural effusions (Roberts et al, 2010).…”

Prognostic Values of VEGF and Endostatin with Malignant Pleural Effusions in Patients with Lung Cancer

“…For lung cancer patients with MPE, the goals of treatment are to evacuation of the pleural fluid, prevention of reaccumulation and prolong survival (Roberts et al, 2010;Heffner et al, 2008). Some angiogenesis inhibitors such as Bevacizumab, a recombinant humanized monoclonal antibody to VEGF, and Endostar, a modified and recombinant human endostatin, either intravenously or intrapleurally, when combined with chemotherapy, have been shown to be efficient in suppressing the accumulation of pleural fluid (Hama et al, 2011;Kitamura et al, 2013;Du et al, 2013).…”

Nonintubated Videothoracoscopic Operations in Thoracic Oncology

“…These figures appear to be remarkably higher that those observed after bedside instillation of talc [68,70] or other agents [63,79]. We have evaluated comparatively the results obtained in a large series of patients with malignant pleural effusion, who were treated by either standard videothoracoscopy or NITOS.…”

“…Therefore, they are expected to benefit at most by avoidance of general anesthesia and OLV, which also appear to be disproportionate against the relatively simplicity of the procedure [45,[61][62][63].…”