Purpose: To determine the prognostic value of pleural
fluid pH, pleural fluid glucose, extent of pleural carcinomatosis (EPC)
score, and Karnofsky Performance Scale (KPS) score in patients with
recurrent symptomatic malignant pleural effusions.
Design: Prospective 53-month study.
Setting: Referral center for interventional
Patients: Eighty-five consecutive
patients (42 men and 43 women) with recurrent symptomatic malignant
pleural effusions who were referred to the interventional pulmonary
service for thoracoscopic pleurodesis.
Pleural fluid pH, pleural fluid glucose, EPC score, and KPS score.
Results: The KPS score was the only statistically
significant predictor variable. Patients with a KPS score ≥ 70 had a
median survival of 395 days, as opposed to a median survival of only 34
days for patients with a KPS score ≤ 30. No prognostic advantage was
evident when patients were categorized by pleural fluid pH, pleural
fluid glucose, or EPC score.
assessing the prognosis of a patient with a recurrent symptomatic
malignant pleural effusion, only the KPS score at the time of
thoracoscopy is predictive of survival. Pleural fluid pH, pleural fluid
glucose, and EPC scores are not as reliable as initially reported. For
patients with a KPS score ≥ 70, it may be very reasonable to proceed
with thoracoscopic talc pleurodesis for management of their malignant