The treatment of malignant pleural effusions

Abstract

One hundred thirty‐three patients with 154 treated malignant pleural effusions were reviewed. Carcinoma of the breast, bronchogenic carcinoma, and lymphomas were the most frequent tumors causing malignant pleural effusion. Cytologies were positive in 67% of the 125 effusions examined. Local treatment consisted of thoracentesis, tube thoracostomy with or without nitrogen mustard instillation, irradiation, or pleurectomy. Patients were followed for recurrence of effusion and return of symptoms for an average of 6 1/2 months. Statistical analysis showed that 37% of 66 hemithoraces (60 patients) treated with tube thoracostomy and nitrogen mustard were free of effusion 3 months after treatment, and 29% 6 months after therapy. Fifty‐three percent of these patients were asymptomatic at 6 months, and 39% at 1 year after treatment. Thoracentesis with or without nitrogen mustard instillation was distinctly inferior to the tube and nitrogen mustard method. Pleurectomy in selected cases proved worthwhile.

Autocrine IL-6-induced Stat3 activation contributes to the pathogenesis of lung adenocarcinoma and malignant pleural effusion

“…Approximately 15% of lung cancer patients have a pleural effusion at the time of initial diagnosis, and 50% develop a pleural effusion later in their courses (Anderson et al, 1974;Memon and Zawadzki, 1981). Patients with malignant pleural effusion (MPE) have a short life expectancy and are difficult to manage clinically (Naito et al, 1997;Sugiura et al, 1997).…”

Pleuropneumonectomy in the management of diffuse malignant mesothelioma of the pleura. Experience with 29 patients.

“…Analysis of the hospital mortality (Table V) (Prorok and Nealon, 1968), pleuroscopy and poudrage (Scarbonchi and Razzouk, 1967), and simple pleurectomy (Merlier, le Brigand, and Wapler, 1968;Lanitis and Waridel, 1973), the latter having the additional advantage of pain relief. However, the most satisfactory means of achieving pleural symphysis appears to be tube drainage with maintained suction and the introduction of cytotoxic agents (Leininger, Barker, and Langston, 1969;Anderson, Philpott, and Ferguson, 1974), the latter causing adhesion largely by their irritant action on the pleural surfaces. Pain due to chest wall involvement is most effectively relieved by palliative radiotherapy (Schlienger et al, 1969).…”

Diagnostic implications of telomerase activity in pleural effusions

“…Similarly, the current data show that the rate of definitive cytological diagnosis obtained from single samples was 54% in malignant pleural effusions. Conversely, some malignancies, such as Hodgkin9s disease, show a lesser rate of diagnostic cytology (23%), while the cytological diagnostic yield ranges 63-73% in lung, metastatic breast and ovarian cancers [12]. Despite the fact that the overall rate for definitive cytological diagnosis was 54% in this study, cytological diagnostic yield was 66% in lung cancer and 60% in either metastatic breast or ovarian cancers, which is consistent with these findings.…”