P2.04-045 Management of Malignant Pleural Effusions: Ten Years’ Experience of a Single Center: Topic: Esophageal Cancer and Other Malignancies

Abstract

Malignant pleural effusions (MPE) are a common clinical problem for patients with neoplastic disease. MPE may be an accompanying sign of them and sometimes the first sign. This study is an overview of diagnosis and treatment of MPE and its aim is to assess the role of invasive procedures in management of such patients. This is a retrospective study for a period of ten years where have been examined all clinical cartels of patients with pleural effusions. All date are analyzed with Pearson Chi-Square test. This study has demonstrated that MPE represent 10% of all pleural effusions. 46% of them have been smokers. 53% of MPE was in the right hemithorax, 38% in the left hemithorax and only 9% was bilateral. The age range was (18-91), and the average age was 63 years old. 37% of these patients have had recent surgery for neoplasia, and in 27% there is no information for recent malignancy and pleural fluid was the first sign of patients. 14% of these patients have relatives with neoplasia. 48% of the cases underwent to biopsy via Video Assisted Thoracic Surgery (VATS) meanwhile for the others the diagnosis was decided by fibrobronchoscopy. In 90% of cases the definitive surgical treatment was pleural drainage and chemical pleurodesis(sol betadine 20 ml + sol NaCl 0,9% 80 ml), in 5% of cases the patient underwent to partial pleurectomy and in 5% of cases wasn’t performed any surgical procedure. Hospitalization day average was 9 days. Performance status was: in 60.2% of cases improved, in 37.2% of cases the same and 2.3% of cases died in hospital. Positive result of pleural biopsy was in 97% of cases. The main hystotype was Adenocarcinoma of lung in men (35% of cases) and Ductal carcinoma of breast (18% of cases) followed by Adenocarcinoma of lung (10% of cases) in women. Mesotelioma was found in 7% of cases. Pleural fluid analysis and cytology should continue to be a first-line investigation to screen out the suspiciously MPE cases, as it is a very convenient, cost-effective and safe investigation. Its combination with pleural biopsy through VATS represents the key of success in diagnosing pleural malignant lesions. The most appropriate surgical treatment for MPE seems to be pleural drainage and chemical pleurodesis because of their origin mostly extrapleural malignancy.