PURPOSE: Chemical pleurodesis is accepted palliative therapy for patients with recurrent, symptomatic malignant pleural effusions. The purpose of the study was to evaluate the efficacy and safety of talc pleurodesis.
METHODS: Sixty consecutive patients with biopsy-proven malignant pleural disease and recurrent symptomatic malignant pleural effusions were eligible to participate in this study. Five grams of talc mixed in 150 mL of normal saline was administered via tube thoracostomy or small-bore catheters after complete drainage of the pleural effusion.
RESULTS: There were 29 female and 31 male patients, with a mean (±SD) age of 61.9 ± 11.8. The final causes of effusions were malignant mesothelioma in 32 patients (53.3%) and metastatic pleural effusion in 28 (46.7%). Three patients were not included in the analysis because of early death or lost to follow-up. The overall success rate was 78.9%. Overall, pleurodesis were successful in 24 patients (77.4%) with malignant mesothelioma, and in 21 patients (80.8%) with other organ metastases. No significant differences were found between the outcome of pleurodesis and histopathologic types of malignant disease (p≥0.05). Successful pleurodesis, defined objectively on chest radiograph, was achieved with 9/12 small-bore catheter (75%) and 36/45 large bore chest tube (80%) (p=0.702). Although there were trends suggesting shorter times to pleurodesis for patients with large-bore chest tube, there were no statistical significant differences in overall response at 30 days, average total duration of tube placement, chest tube output ranged, and complication rate. The most common side effects of talc pleurodesis was fever (38.3%) and chest pain (13.3%). The serious complication was empyema in 1 patient, hypotension in 1 patient, and atrial arrhythmia in 1 patient.
CONCLUSION: In conclusion, talc pleurodesis can be used as effective and safe method in the control of malignant pleural effusions.
CLINICAL IMPLICATIONS: In clinical practice, pleurodesis with talc is a simple and acceptable procedure with high efficacy for controlling malignant pleural effusions, especially when applied on appropriate patients.
DISCLOSURE: Muzaffer Metintas, None.