Malignant pleural effusion (MPE) is a common complication in patients with primary or refractory cancer, and a poor prognostic factor. When the effusion is diagnosed, the majority of patients have several objective and subjective symptoms such as cough, dyspnea, anxiety, anorexia, which are difficult to be managed. The aim of this study was to analyze the usefulness of video-assisted thoracoscopic (VATS) thoracentesis and talc pleurodesis (TP) in improving quality of life of patients with symptomatic MPE, according to the causes on this complication. Methods: Two Groups of sex- and age-matched patients with MPE (21 men, 13 women, median age 66 years, range 45-87 years) underwent VATS thoracentesis and TP: Group 1 (N = 18 patients) with MPE due to advanced lung cancer, and Group 2 (N = 16) with MPE due to metastases from extra-thoracic cancer. All patients were asked to report their functional limitations and health-related quality of life (QoL) by filling the Medical Outcomes Study Short Form (MOS-SF-36) questionnaire, preoperatively and at discharge. Results: Talc (Steritalc, Novatech, La Ciotat, France) was administered by a pneumatic atomizer, and the duration of VATS procedure was 26 ± 10 minutes. As expected, there was a significant correlation between amount of MPE (1920 ± 968 mL) and preoperative MOS-SF-36 score (R = 0.38, p = 0.03), which did not differ between Groups (p = NS), and was independent of age of patients (R = 0.32, p = 0.07). The postoperative scores are reported in the Table. Only two parameters (social function and role emotional) improved more in Group 1 compared to Group 2, but the overall improvement of the score was not different (p = NS) between the two Groups. In conclusion, VATS thoracentesis and TP leads to similar advantages in patients with MPE due to lung cancer or metastases. Therefore, this minimally-invasive treatment should be performed in all patients with MPE independently of the cause of pleural effusion.
Improved quality of life of patients with malignant pleural effusion who underwent video-assisted minimally invasive thoracentesis and talc pleurodesis
LUMACHI, FRANCO;
2015
Abstract
Malignant pleural effusion (MPE) is a common complication in patients with primary or refractory cancer, and a poor prognostic factor. When the effusion is diagnosed, the majority of patients have several objective and subjective symptoms such as cough, dyspnea, anxiety, anorexia, which are difficult to be managed. The aim of this study was to analyze the usefulness of video-assisted thoracoscopic (VATS) thoracentesis and talc pleurodesis (TP) in improving quality of life of patients with symptomatic MPE, according to the causes on this complication. Methods: Two Groups of sex- and age-matched patients with MPE (21 men, 13 women, median age 66 years, range 45-87 years) underwent VATS thoracentesis and TP: Group 1 (N = 18 patients) with MPE due to advanced lung cancer, and Group 2 (N = 16) with MPE due to metastases from extra-thoracic cancer. All patients were asked to report their functional limitations and health-related quality of life (QoL) by filling the Medical Outcomes Study Short Form (MOS-SF-36) questionnaire, preoperatively and at discharge. Results: Talc (Steritalc, Novatech, La Ciotat, France) was administered by a pneumatic atomizer, and the duration of VATS procedure was 26 ± 10 minutes. As expected, there was a significant correlation between amount of MPE (1920 ± 968 mL) and preoperative MOS-SF-36 score (R = 0.38, p = 0.03), which did not differ between Groups (p = NS), and was independent of age of patients (R = 0.32, p = 0.07). The postoperative scores are reported in the Table. Only two parameters (social function and role emotional) improved more in Group 1 compared to Group 2, but the overall improvement of the score was not different (p = NS) between the two Groups. In conclusion, VATS thoracentesis and TP leads to similar advantages in patients with MPE due to lung cancer or metastases. Therefore, this minimally-invasive treatment should be performed in all patients with MPE independently of the cause of pleural effusion.Pubblicazioni consigliate
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