Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Wiener klinische Wochenschrift 23-24/2015

01.12.2015 | short report

Talc pleurodesis improves survival of patients with malignant pleural effusions: case-control study

verfasst von: MD Marta Korsic, Sonja Badovinac, Branka Cucevic, Zoran Janevski

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 23-24/2015

Einloggen, um Zugang zu erhalten
share
TEILEN

Summary

Aim

The aim of this study is to investigate whether there was a considerable difference in the survival of patients with malignant pleural effusion (MPE) depending on the pleural effusion treatment option.

Methods

One hundred and seven patients with proven MPE (metastatic lung and breast cancer) were included in the retrospective study. Fifty six patients were treated with talc pleurodesis and a control group of 51 patients with similar characteristics (in age, sex and disease) were treated with serial thoracentesis. The patients of both groups underwent chemotherapy and/or radiotherapy. The overall survival and the survival in subgroups of patients with different tumour types and different performance status (PS) equal 1, 2 and 3 were compared.

Results

The patients who underwent talc pleurodesis had a longer average survival interval (MS) than the patients without such a treatment (n = 56; MS = 21,5 and n = 51; MS = 9 weeks, respectively; p < 0.001). The best results were achieved in patients with PS 1 (n = 16; MS = 35.5 and n = 10; MS = 11 weeks in the groups with and without talc pleurodesis, respectively; p < 0,001) and PS 2 (n = 27; MS = 21 and n = 30; MS = 10 weeks in the groups with and without talc pleurodesis, respectively; p < 0.001), whereas talc pleurodesis was not effective in PS 3 patients (n = 13; MS = 10 and n = 11; MS = 7 weeks in the groups with and without talc pleurodesis, respectively; p = 0.08). Patients with the breast cancer showed a longer average survival interval after pleurodesis than those with the lung cancer (n = 12; MS = 37.5 and n = 44; MS = 20 weeks in the group with the breast cancer and with the lung cancer, respectively; p < 0.001), whereas the median survival was not significantly different between those patients without pleurodesis (n = 10; MS = 10 and n = 41; MS = 9 weeks in the group with the breast cancer and lung cancer, respectively; p = 0.11).

Conclusion

The patients treated with talc pleurodesis had a significantly longer average survival than the patients without such a treatment, especially in the group with the breast cancer and in groups with better performance status. This may indicate that talc pleurodesis, apart from its symptomatic effect on the cessation of pleural effusion, may have a direct antitumour effect as well.
Literatur
1.
Zurück zum Zitat Yim APC, Chan ATC, Lee TW, Wan IYP, Ho JKS. Thoracoscopic talc insufflation versus talc slurry for symptomatic malignant pleural effusion. Ann Thorac Surg. 1996;62:1655–8. CrossRefPubMed Yim APC, Chan ATC, Lee TW, Wan IYP, Ho JKS. Thoracoscopic talc insufflation versus talc slurry for symptomatic malignant pleural effusion. Ann Thorac Surg. 1996;62:1655–8. CrossRefPubMed
2.
Zurück zum Zitat Rodrigez-Panadero F, Antony VB. Pleurodesis: state of the art. Eur Respir J. 1997;10:1648–54. CrossRef Rodrigez-Panadero F, Antony VB. Pleurodesis: state of the art. Eur Respir J. 1997;10:1648–54. CrossRef
3.
Zurück zum Zitat Bethune N. A new technique for the deliberate production of pleural adhesions as a preliminary to lobectomy. J Thorac Surg 1935;4:251–61. Bethune N. A new technique for the deliberate production of pleural adhesions as a preliminary to lobectomy. J Thorac Surg 1935;4:251–61.
4.
Zurück zum Zitat Rodriguez-Panadero F, Montes-Worboys A. Mechanism of Pleurodesis. Respiration. 2012;83(2):91–8. doi:10.1159/000335419. Epub 2012 Jan 20. Review. CrossRefPubMed Rodriguez-Panadero F, Montes-Worboys A. Mechanism of Pleurodesis. Respiration. 2012;83(2):91–8. doi:10.1159/000335419. Epub 2012 Jan 20. Review. CrossRefPubMed
5.
Zurück zum Zitat Kennedy L, Harley RA, Sahn SA, Strange C. Talc slurry pleurodesis. Pleural fluid and histological analysis. Chest. 1995;107(6):1707–12. CrossRefPubMed Kennedy L, Harley RA, Sahn SA, Strange C. Talc slurry pleurodesis. Pleural fluid and histological analysis. Chest. 1995;107(6):1707–12. CrossRefPubMed
6.
Zurück zum Zitat Krismann M, Pieper K, Muller KM. Pleural reaction pattern after talc pleurodesis. Pathology. 1998;19(3):214–20. CrossRef Krismann M, Pieper K, Muller KM. Pleural reaction pattern after talc pleurodesis. Pathology. 1998;19(3):214–20. CrossRef
7.
Zurück zum Zitat Schwarz Y, Star A. Role of talc modulation on cytokine activation in cancer patients undergoing pleurodesis. Pulm Med. 2012;2012:806183. doi:10.1155/2012/806183. Epub 2012 Mar 7. PubMedCentralCrossRefPubMed Schwarz Y, Star A. Role of talc modulation on cytokine activation in cancer patients undergoing pleurodesis. Pulm Med. 2012;2012:806183. doi:10.1155/2012/806183. Epub 2012 Mar 7. PubMedCentralCrossRefPubMed
8.
Zurück zum Zitat Viallat JR, Rey F, Astoul P, Boutin C. Thoracoscopic talk poudrage. Pleurodesis for malignant pleural effusions—a review of 360 cases. Chest. 1996;110:1387–93. CrossRefPubMed Viallat JR, Rey F, Astoul P, Boutin C. Thoracoscopic talk poudrage. Pleurodesis for malignant pleural effusions—a review of 360 cases. Chest. 1996;110:1387–93. CrossRefPubMed
9.
Zurück zum Zitat Sanchez-Armengol A, Rodrigez-Panadero F. Survival and talc pleurodesis in metastatic pleural carcinoma, revisited. Report of 125 cases. Chest. 1993;104:1482–5. CrossRefPubMed Sanchez-Armengol A, Rodrigez-Panadero F. Survival and talc pleurodesis in metastatic pleural carcinoma, revisited. Report of 125 cases. Chest. 1993;104:1482–5. CrossRefPubMed
10.
Zurück zum Zitat Martinez-Miragon E, Aparicio J, Sanchis J, Menendez R, Cruz M, Sanchis F. Malignant pleural effusion: prognostic factors for survival and response to chemical pleurodesis in a series of 120 cases. Respiration. 1998;65:108–13. CrossRef Martinez-Miragon E, Aparicio J, Sanchis J, Menendez R, Cruz M, Sanchis F. Malignant pleural effusion: prognostic factors for survival and response to chemical pleurodesis in a series of 120 cases. Respiration. 1998;65:108–13. CrossRef
11.
Zurück zum Zitat Burrows CM, Mathews WC, Colt HG. Predicting survival in patients with recurrent symptomatic malignant pleural effusions: an assessment of the prognostic values of physiologic, morphologic, and quality of life measures of extent of disease. Chest. 2000;117:73–8. CrossRefPubMed Burrows CM, Mathews WC, Colt HG. Predicting survival in patients with recurrent symptomatic malignant pleural effusions: an assessment of the prognostic values of physiologic, morphologic, and quality of life measures of extent of disease. Chest. 2000;117:73–8. CrossRefPubMed
12.
Zurück zum Zitat de Campos JR, Vargas FS, de Capmos Werebe E, et al. Thoracoscopy talc poudrage: a 15-year experience. Chest. 2001;119:801–6. CrossRefPubMed de Campos JR, Vargas FS, de Capmos Werebe E, et al. Thoracoscopy talc poudrage: a 15-year experience. Chest. 2001;119:801–6. CrossRefPubMed
13.
Zurück zum Zitat Nasreen N, Mouhammed KA, Dowling PA, et al. Talc induces apoptosis in human malignant mesothelioma cells in vitro. Am J Respir Crit Care Med. 2000;161:595–600. CrossRefPubMed Nasreen N, Mouhammed KA, Dowling PA, et al. Talc induces apoptosis in human malignant mesothelioma cells in vitro. Am J Respir Crit Care Med. 2000;161:595–600. CrossRefPubMed
14.
Zurück zum Zitat Najmunisa N, Mohamed KA, Brown S, Su J, Sriram PS, Moudgil B, Loddenkemper R, Antony VB. Talc mediates angiostasis in malignant pleural effusions via endostatin induction. Eur Respir J. 2007;29:761–9. CrossRef Najmunisa N, Mohamed KA, Brown S, Su J, Sriram PS, Moudgil B, Loddenkemper R, Antony VB. Talc mediates angiostasis in malignant pleural effusions via endostatin induction. Eur Respir J. 2007;29:761–9. CrossRef
15.
Zurück zum Zitat Šamija M i suradnici. Onkologija. Zagreb: Medicinska naklada; 2000. Šamija M i suradnici. Onkologija. Zagreb: Medicinska naklada; 2000.
16.
Zurück zum Zitat Kaplan ZL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–81. CrossRef Kaplan ZL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–81. CrossRef
17.
Zurück zum Zitat Molengraft van de FJJM, Vooijs GP. Survival of petients with malignancy-associated effusions. Acta Cytol. 1989;33:911–6. PubMed Molengraft van de FJJM, Vooijs GP. Survival of petients with malignancy-associated effusions. Acta Cytol. 1989;33:911–6. PubMed
18.
Zurück zum Zitat Tan C, Sedrakyan A, Browne J, Swift S, Treasure T. The evidence on the effectivness of management for malignant pleural effusion: a systemic review. Eur J Cardiothorac Surg. 2006;29:829–38. CrossRefPubMed Tan C, Sedrakyan A, Browne J, Swift S, Treasure T. The evidence on the effectivness of management for malignant pleural effusion: a systemic review. Eur J Cardiothorac Surg. 2006;29:829–38. CrossRefPubMed
19.
Zurück zum Zitat Shaw P, Agarwal R. Pleurodesis for malignant pleural effusions. Cochrane Datebase Sys Rev. 2004;(1):CD002916. Shaw P, Agarwal R. Pleurodesis for malignant pleural effusions. Cochrane Datebase Sys Rev. 2004;(1):CD002916.
20.
Zurück zum Zitat Steger V, Mika U, Toomes H, Walker T, Engel C, Kyriss T, et al. Who gains most?A 10-year experience with 611 thoracoscopic talc pleurodesis. Ann Thorac Surg. 2007;83:1940–5. CrossRefPubMed Steger V, Mika U, Toomes H, Walker T, Engel C, Kyriss T, et al. Who gains most?A 10-year experience with 611 thoracoscopic talc pleurodesis. Ann Thorac Surg. 2007;83:1940–5. CrossRefPubMed
21.
Zurück zum Zitat Viallat JR, Boutin C. Malignant pleural effusions: recourse to early use of talc. Rev Med Interne. 1998;19:811–8. CrossRefPubMed Viallat JR, Boutin C. Malignant pleural effusions: recourse to early use of talc. Rev Med Interne. 1998;19:811–8. CrossRefPubMed
22.
Zurück zum Zitat Genofre EH, Marchi E, Vargas FS. Inflammation and clinical repercussions of pleurodesis induced by intrapleural talk administration. Clinics (Sao Paulo). 2007;62:627. CrossRef Genofre EH, Marchi E, Vargas FS. Inflammation and clinical repercussions of pleurodesis induced by intrapleural talk administration. Clinics (Sao Paulo). 2007;62:627. CrossRef
23.
Zurück zum Zitat Lee P, Sun L, Lim CK, Aw SE Selective apoptosis of lung cancer cells with talc. Eur Respir J. 2010;35(2):450–2. doi:10.1183/09031936.00113109. CrossRefPubMed Lee P, Sun L, Lim CK, Aw SE Selective apoptosis of lung cancer cells with talc. Eur Respir J. 2010;35(2):450–2. doi:10.1183/09031936.00113109. CrossRefPubMed
24.
Zurück zum Zitat Kolschmann S, Ballin A, Gillissen A. Clinical efficacy and safety of thoracoscopic talc pleurodesis in malignant pleural effusions. Chest. 2005;128:1431–5. CrossRefPubMed Kolschmann S, Ballin A, Gillissen A. Clinical efficacy and safety of thoracoscopic talc pleurodesis in malignant pleural effusions. Chest. 2005;128:1431–5. CrossRefPubMed
25.
Zurück zum Zitat Naito T, Saoth H, Ishikawa H, et al. Pleural effusion as a significant prognostic factor in non-small cell lung cancer. Anticancer Respir. 1997;17:4743–6. Naito T, Saoth H, Ishikawa H, et al. Pleural effusion as a significant prognostic factor in non-small cell lung cancer. Anticancer Respir. 1997;17:4743–6.
26.
Zurück zum Zitat Love D, White D, Kiroff G. Thoracoscopic talc pleurodesis for malignant pleural effusion. ANZ J Surg. 2003;73:19–22. CrossRefPubMed Love D, White D, Kiroff G. Thoracoscopic talc pleurodesis for malignant pleural effusion. ANZ J Surg. 2003;73:19–22. CrossRefPubMed
27.
Zurück zum Zitat Hirata T, Yonemori K, Hirakawa A, Shmizu C, TamuraK, Ando M, Katsumata N, Tanimoto M, Fujiwara Y. Efficacy of pleurodesis for malignant pleural effusions in brest cancer patients. Eur Respir J. 2011;38(6):1425–30. doi:10.1183/09031936.00171610. Epub 2011 May 12. CrossRefPubMed Hirata T, Yonemori K, Hirakawa A, Shmizu C, TamuraK, Ando M, Katsumata N, Tanimoto M, Fujiwara Y. Efficacy of pleurodesis for malignant pleural effusions in brest cancer patients. Eur Respir J. 2011;38(6):1425–30. doi:10.1183/09031936.00171610. Epub 2011 May 12. CrossRefPubMed
28.
Zurück zum Zitat Radić I, Vučak I, Milošević J, Maršić A, Vukičević S, Marušić M. Immunosuppression induced by talc granulomatosis in the rat. Clin Exp Immunol. 1988;73:316–21. PubMedCentralPubMed Radić I, Vučak I, Milošević J, Maršić A, Vukičević S, Marušić M. Immunosuppression induced by talc granulomatosis in the rat. Clin Exp Immunol. 1988;73:316–21. PubMedCentralPubMed
29.
Zurück zum Zitat Singer JJ, Jones JC, Tragerman LJ, et al. Aseptic pleuritis experimentally produced. J Thorac Surg. 1941;10:151–83. Singer JJ, Jones JC, Tragerman LJ, et al. Aseptic pleuritis experimentally produced. J Thorac Surg. 1941;10:151–83.
30.
Zurück zum Zitat Malthlouthi A, Chabchoub A, Labbene N, et al. Etude anatomopathologique experimetale du talcage pleural. Rev Mal Respir. 1992;9:617–21. Malthlouthi A, Chabchoub A, Labbene N, et al. Etude anatomopathologique experimetale du talcage pleural. Rev Mal Respir. 1992;9:617–21.
31.
Zurück zum Zitat Van den Heuvel MM, Smit HJ, Barbierato SB, Havenith CE, Beelen Postmus PE. Talc-induced inflammation in pleural cavity. Eur Respir J. 1998;12(6):1419–23. CrossRefPubMed Van den Heuvel MM, Smit HJ, Barbierato SB, Havenith CE, Beelen Postmus PE. Talc-induced inflammation in pleural cavity. Eur Respir J. 1998;12(6):1419–23. CrossRefPubMed
32.
Zurück zum Zitat Nasreen N, Hartman LD, Mohamed KA, Antony VB. Talc-induced expression of C-C and C-X-C chemokines and intercellular adhesion molecule-1 in mesothelial cells. Am J Respir Crit Care Med. 1998;156:971–78. CrossRef Nasreen N, Hartman LD, Mohamed KA, Antony VB. Talc-induced expression of C-C and C-X-C chemokines and intercellular adhesion molecule-1 in mesothelial cells. Am J Respir Crit Care Med. 1998;156:971–78. CrossRef
Metadaten
Titel
Talc pleurodesis improves survival of patients with malignant pleural effusions: case-control study
verfasst von
MD Marta Korsic
Sonja Badovinac
Branka Cucevic
Zoran Janevski
Publikationsdatum
01.12.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 23-24/2015
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-015-0716-8