Regarding the study by Dresler et al,3 we agree that the post hoc subset analysis showing a better efficacy of TTP over talc slurry is, at best, hypothesis generating. However, we would like to point out that the complications reported in the TTP arm were staggering, with blood transfusion, atelectasis, pneumonia, respiratory failure, and postoperative death in 4.5%, 1.3%, 9.3%, 8.1%, and 8.4% of patients, respectively. These results do not reflect those described by pulmonologists around the world. It is difficult to argue against the large body of safety data for talc pleurodesis in light of two multicenter prospective European studies.4,5 To answer Dr Light’s concern about the study by Janssen et al,4 one of the authors (P. A.) was involved in both studies and can attest to the extreme caution used in determining the causes of respiratory manifestation observed after talc pleurodesis.