Malignant pleural effusions and their treatment by intercostal talc pleurodesis

doi:10.1016/0007-0971(79)90030-5

British Journal of Diseases of the Chest

Volume 73, 1979, Pages 173-177

https://doi.org/10.1016/0007-0971(79)90030-5 Get rights and content

Abstract

An analysis is presented of 44 patients with malignant pleural effusion treated by intercostal talc pleurodesis, all except eight of them between 1966 and 1971.

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Cited by (13)

Comparative study of EGFR mutations detected in malignant pleural effusion, plasma and tumor tissue in patients with adenocarcinoma of the lung
2019, Lung Cancer
Citation Excerpt :
Lung cancer tissue obtained by surgery or biopsy is commonly used for categorizing tumors for clinical decisions [2–4], however, because in patients considered for EGFR-TKI therapy present in advanced stages, diagnostic materials are often limited to small biopsies, which may contain insufficient tumor cells for molecular analysis [5], approaches to detect molecular markers from samples other than surgical tissue must be explored to select more patients who are likely to respond to TKI treatment [6,7]. Malignant pleural effusion (MPE) is a common complication of advanced NSCLC, and adenocarcinoma is the most common cell type [8]. Sampling of effusion fluid is minimally invasive, often easy, and sometimes necessary in patients with symptoms of pain or dyspnea.
The utility of malignant pleural effusion (MPE) as a source for determining EGFR mutations to guide EGFR TKI therapy in advanced adenocarcinoma of the lung remains unclear. This study compared MPE, plasma and tumor tissues as sources of biological samples for EFGR mutational analysis of lung adenocarcinoma patients.
Total 295 MPE samples were retrospectively collected from lung adenocarcinoma patients. Matched tissue and plasma samples were available for 92 patients, and 248 patients had plasma samples. EGFR exon-19-deletion and exon 21-L858R mutation were detected with Denaturing high performance liquid chromatography (DHPLC). The concordance of EGFR mutation status in MPE, tissue, and plasma were evaluated, and the value of EGFR mutations in MPE with respect to efficacy of EGFR-TKI was investigated.
The EGFR mutation rate in MPE samples was 39.3% (116/295). The concordance between MPEs and tissues was 87.1% (Kappa = 0.71); the sensitivity and specificity of EGFR mutation in MPEs according to tissues was 71.4% and 96.5%, respectively. And 219 patients received EGFR-TKI, and the objective response rate was similar for patients with EGFR mutation either in MPE, tissues or plasma (57.6% vs 56.0% vs 47.4%, p = 0.51). Similar results were found in progression free survival (8.9 months vs 9.0 months vs 7.7 months, p = 0.077 and overall survival (29.8 months vs 25.9 months vs 25.3 months, p = 0.33).
MPE is a reliable surrogate for tumor tissue for identifyingEGFR mutations. MPE could offer reference of EGFR mutation to EGFR-TKIs treatment decision for advanced lung adenocarcinoma patients even when tissue and plasma were available.
The management of malignant pleural and pericardial effusions
1997, Hematology/Oncology Clinics of North America
Pleurodesis using talc slurry
1994, Chest
Objective: To determine the efficacy and safety of talc slurry for pleurodesis.
Design: Retrospective.
Participants: All patients who received talc slurry via tube thoracostomy at Memorial Sloan-Kettering Cancer Center from March 1991 to April 1992.
Results: Fifty-eight patients received talc slurry in 75 procedures; five patients had 2 unilateral procedures and 12 had bilateral procedures. Fifty-two patients had malignant pleural effusions with the most common cell types being breast (23 of 52, 44 percent), lung (4 of 52, 8 percent), ovarian (4 of 52, 8 percent), and endometrial (3 of 52, 6 percent). Four patients had benign conditions. The mean duration of follow-up was 171 days (range, 2 to 450 days). Success, defined as the absence of pleural fluid reaccumulation, was evaluable in 47 of 73 (64 percent) procedures. Pleurodesis was successful in 38 of 47 (81 percent). Adverse effects associated with pleurodesis included fever (46 of 73, 63 percent), empyema (4 of 73, 5 percent), atrial arrhythmia (3 of 73, 4 percent), hypotension (3 of 73, 4 percent), and hypoxemic respiratory failure (3 of 73, 4 percent). There were no deaths attributable to the procedure.
Conclusions: Talc slurry instilled through a chest tube is an effective bedside method of pleurodesis. Fever occurs frequently. Respiratory failure is a rare but potentially serious complication that deserves further investigation.
Talc pleurodesis for the treatment of pneumothorax and pleural effusion
1994, Chest
Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010
2010, Thorax
Citation Excerpt :
The diagnostic yield and accuracy of thoracoscopy for malignant effusions is >90%.99 125 127 130 131 Talc poudrage performed during thoracoscopy is an effective method for controlling malignant effusions with a pleurodesis success rate of 77–100%.6 68 97 132–138 Randomised studies have established the superiority of talc poudrage over both bleomycin and tetracyclines (see evidence table available on the BTS website at www.brit-thoracic.org.uk).73 76–78
The role of surgery in diffuse malignant mesothelioma of the pleura
1981, Seminars in Oncology

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General articleMalignant pleural effusions and their treatment by intercostal talc pleurodesis

Abstract

Dis. Chest

Surg. Clins N. Am.

J. thorac. cardiovasc. Surg.

J. thoracic. cardiovasc. Surg.

J. thorac. Surg.

Recurrent malignant pleural effusions and talc aerosol treatment

Surgery, St Louis

The management of pleural effusions and chylothorax in lymphoma

Radiology

Palliative treatment of neoplastic pleural effusion with intercostal intubation and talc instillation

W. J. Surg.

Treatment of chylothorax by producing pleurodesis using iodized talc

Thorax

General article
Malignant pleural effusions and their treatment by intercostal talc pleurodesis