Talc pleurodesis in malignant pleural effusion: a systematic review and meta-analysis

Beltsios, Eleftherios T.; Mavrovounis, Georgios; Adamou, Antonis

doi:10.1007/s11748-020-01549-2

Cited by 9 publications

(7 citation statements)

References 50 publications

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“…2,10 While it has been reported that the most common cause of MPE is lung cancer, other causes include breast cancer, gastrointestinal system malignancies, hematologic malignancies, and mesothelioma, which is the primary tumour of the pleura. 9,11,12 As a result of our study, we found that primary lung cancer was the most common cause of MPE, followed by mesothelioma and breast cancer Table 3. Grouping of patients as successful talc pleurodesis and unsuccessful talc pleurodesis according to success status and comparison of these groups.…”

Section: Discussionmentioning

confidence: 64%

Uniportal Video-assisted Thoracoscopic Talc Pleurodesis in the Treatment of Malignant Pleural Effusions. Is Early Phase Talc Pleurodesis More Effective?

AKSOY,

SEHİTOGULLARI

2023

Online Türk Sağlık Bilimleri Dergisi

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Objective: VATS talk pleurodesis is an effective method for palliatively treating malignant pleural effusion (MPE). This study aimed to compare early and late-phase talc pleurodesis procedures and to determine the factors affecting the success of the uniportal VATS talc pleurodesis procedure. Materials and Methods: The data of 58 patients who underwent uniportal VATS talc pleurodesis due to MPE were analysed retrospectively. The patients were divided into two groups as early-phase talc pleurodesis (n=23, 48.3%) and late-phase (n=25, 51.7%). Groups were compared using Pearson chi-square test and Mann-Whitney U tests. Results: Complications developed in 10 patients (17.2%). No significant difference was found between the early-phase talc pleurodesis and the late-phase pleurodesis regarding complication rate (p=0.905), durations of hospitalisation (p=0.821). It was observed that the early-phase talc pleurodesis procedure had higher success than the late-phase talc pleurodesis procedure (Odds ratio=1.425, 95%CI=0.307-6.624), although not statistically significant (p=0.06). It was determined that 86% of the patients who underwent early talc pleurodesis had no hospital readmission due to MPE within the first 3 months. Conclusion: Uniportal VATS talc pleurodesis is a safe and effective treatment method for malignant pleural effusion, with low complication and high success rates. Early-phase talc pleurodesis procedure significantly reduces recurrent hospitalisations.

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Section: Discussionmentioning

confidence: 64%

Uniportal Video-assisted Thoracoscopic Talc Pleurodesis in the Treatment of Malignant Pleural Effusions. Is Early Phase Talc Pleurodesis More Effective?

AKSOY,

SEHİTOGULLARI

2023

Online Türk Sağlık Bilimleri Dergisi

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“…To investigate the role of the PS during airway infection, we specifically and significantly reduced the number of immune cells in the pleural space compartment by intra-pleural injection of talc ( Figure S1 ), a technique currently used in the clinic to prevent recurrent malignant pleural effusion ( 24 , 25 ). Compared to controls, mice treated with talc displayed a higher mortality upon E. coli airway infection over time ( Figure 1A ).…”

Section: Resultsmentioning

confidence: 99%

Pleural Resident Macrophages and Pleural IRA B Cells Promote Efficient Immunity Against Pneumonia by Inducing Early Pleural Space Inflammation

et al. 2022

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Airway infection is a major cause of mortality worldwide. The identification of new mechanisms aiding in effective host immune response is therefore required. Here, we show that the specific depletion of the pleural immune cell compartment during bacterial pneumonia resulted in a reduced pulmonary immune response and increased mortality in mice. Bacterial airway infection provoked early pleural space (PS) inflammation characterized by innate response activator (IRA) B cell development and pleural large resident macrophage (LRM) necroptosis, the repopulation of LRMs being driven by cellular proliferation in situ. Necroptotic LRMs amplified PS inflammation by stimulating pleural Mincle-expressing macrophages whereas IRA B cells contributed partially to GM-CSF-induced PS inflammation. Upon pulmonary infection, the induction of PS inflammation resulted in reduced bacterial burden whereas the specific depletion of pleural resident macrophages led to increased mortality and bacterial burden and reduced pulmonary immunity. Moreover, mice in which B cells were unable to produce GM-CSF exhibited reduced CD103+ dendritic cells and reduced CD4+ T cell numbers in the draining lymph node. Altogether, our results describe a previously unrecognized mechanism of pleural space inflammation necessary for effective protection against bacterial airway infection.

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“…Of these, talc demonstrated significantly improved pleurodesis when compared to bleomycin in the subgroup analysis. When compared to alternative chemical agents combined, talc demonstrated a significant advantage (Relative Risk: 1.26 (CI 1.13, 1.40), p < 0.0001) [ 43 ]. Despite the recommendation that graded talc remain the preferred sclerosing agent, availability and cost may be prohibitive in some locations.…”

Section: Managementmentioning

confidence: 99%

Malignant Pleural Effusions: Updates in Diagnosis and Management

Hughes

Carmichael

2022

Life

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Malignant pleural effusions remain a significant clinical problem resulting in greater than 125,000 hospitalizations per year and leading to over 5 billion dollars in healthcare utilization costs. Not only are health care expenditures related to malignant pleural effusion significant, but malignant pleural effusions also often result in significant patient discomfort and distress, largely at the end of life. Advances in management over the past several years have provided patients with greater autonomy as they are able to provide self-aid at home either alone or with family assistance. Additionally, practice changes have allowed for fewer interventions allowing patients to spend more time out of the clinic or inpatient wards.

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Talc pleurodesis in malignant pleural effusion: a systematic review and meta-analysis

Cited by 9 publications

References 50 publications

Uniportal Video-assisted Thoracoscopic Talc Pleurodesis in the Treatment of Malignant Pleural Effusions. Is Early Phase Talc Pleurodesis More Effective?

Uniportal Video-assisted Thoracoscopic Talc Pleurodesis in the Treatment of Malignant Pleural Effusions. Is Early Phase Talc Pleurodesis More Effective?

Pleural Resident Macrophages and Pleural IRA B Cells Promote Efficient Immunity Against Pneumonia by Inducing Early Pleural Space Inflammation

Malignant Pleural Effusions: Updates in Diagnosis and Management

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