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Disorders of the Pleura |

Quality of Life in Patients With Malignant Pleural Effusion Undergoing Pleurodesis

Ricardo Terra*, PhD; Victor Ishii; Jose Dias Andrade Neto, MD; Milena Suesada, PhD; Paulo Pego-Fernandes, PhD; Fabio Jatene, PhD
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University of São Paulo Medical School, Sao Paulo, Brazil


Chest. 2012;142(4_MeetingAbstracts):489A. doi:10.1378/chest.1389268
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Abstract

SESSION TYPE: Pleural Disease

PRESENTED ON: Sunday, October 21, 2012 at 01:15 PM - 02:45 PM

PURPOSE: Pleurodesis is a palliative procedure which main purpose is to alleviate respiratory symptoms of patients with malignant pleural effusion. Nevertheless, quality-of-life is an outcome rarely explored in literature. The main purpose of this study was to evaluate the quality-of-life before and 30 days after pleurodesis in patients with malignant pleural effusion. The secondary objective was to identify predictors of quality-of-life improvement after pleurodesis.

METHODS: Retrospective study including all patients with recurrent malignant pleural effusion who underwent pleurodesis at Hospital das Clinicas (University of Sao Paulo) and Hospital Aristides Maltez from 2008 until 2011, and who filled out quality-of-life questionnaires before and 30 days after the procedure. In both institutions the World Health Organization-bref general quality-of-life questionnaire has been regularly applied to all patients undergoing pleurodesis since 2007. Paired T-test was used to compare before and after scores and multivariable regression models were used to identify predictors.

RESULTS: During the study period 119 patients were included (24 men, 95 women, mean age 58.3 +- 11.9). The primary tumors were: breast (75), lung (24), ovary (4), lymphoma (11) and other (7). The mean pre-pleurodesis quality-of-life scores were: physical aspect 36.6+-17.2, psychological aspect 59.2+-17.2, social aspect 64.3+-20.1, and environmental aspect 53.1+-14.9. Thirty days after pleurodesis, the physical aspect (8.1 pts, p=0.0001) and the environmental aspect (3.6 pts, p=0.008) improved significantly while the other two aspects remained unchanged. Predictors of improvement of quality-of-life in this sample were: breast cancer (p=0.017), lymphoma (p=0.03), pleural fluid glucose (p=0.012), and low physical aspect score before pleurodesis (p=0.001).

CONCLUSIONS: All aspects of quality-of-life are deeply compromised in patients with recurrent malignant pleural effusion. Pleurodesis improves quality-of-life thirty days after the procedure particularly in patients with breast cancer and with very low physical status scores.

CLINICAL IMPLICATIONS: A better understanding of how quality-of-life is worsened by malignant pleural effusion as well as the role of pleurodesis in improving the quality-of-life of such patients is essential for developing a patient-centered algorithm to manage malignant pleural effusion.

DISCLOSURE: The following authors have nothing to disclose: Ricardo Terra, Victor Ishii, Jose Dias Andrade Neto, Milena Suesada, Paulo Pego-Fernandes, Fabio Jatene

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University of São Paulo Medical School, Sao Paulo, Brazil

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