Our experience and outcomes following indwelling pleural catheter (IPC) insertion at the University Hospital Coventry and Warwickshire (UHCW) and the effect of primary tumour site on outcomes

Abstract

<b>Introduction:</b> IPC’s offer a relatively novel option in the management of recurrent malignant pleural effusions. The respiratory department at UHCW has recently set up an ambulatory pleural clinic offering IPC insertion. The main aim of our study was to assess our outcomes following IPC insertion compared to more established centres. As a secondary aim we investigated whether the primary cancer type affected outcomes. <b>Methods:</b> We conducted a retrospective observational analysis of all patients with recurrent malignant pleural effusion who underwent an IPC insertion at UHCW. Clinical and radiological data was gathered remotely. <b>Results:</b> 25 patients underwent IPC insertion. Mean duration IPC’s remained in-situ; 136 days (range 8-546). 94% patients reported symptom improvement and ongoing drainage at 4 weeks. 30% patients achieved pleurodesis and IPC removal. 2 (8%) cases resulted in complications; 1 blocked IPC &amp; 1 late empyema. Patients with extra thoracic malignancy had shorter durations IPC’s remained insitu 53 vs 150 (lung), 309 (mesothelioma), 9 (haematological) days. Additionally, poorer pleurodesis rates 0% (extra thoracic) vs 42% (lung), 30% (mesothelioma) and 100% (haematological). <b>Conclusion:</b> Our centre has comparable outcomes to published data following IPC insertion. Our subgroup analysis albeit small in number demonstrates a trend towards poorer outcomes in patients whose primary tumour is extra thoracic measured by our primary endpoint. However, this may not reflect the symptomatic improvement experienced by these patients.