PROGNOSTIC FACTORS OF 30-DAY MORTALITY AND RECURRENCE OF MALIGNANT PLEURAL EFFUSION IN HIGH-RISK TUMORS ACCORDING TO THE LENT SCORE STUDY

Abstract

SESSION TITLE: Advances in the Diagnosis of Lung Cancer SESSION TYPE: Original Investigations PRESENTED ON: 10/09/2018 02:30 PM - 03:30 PM PURPOSE: The aim of this study was to identify predictors of 30-day mortality and recurrence after palliative pleural procedures in patients with malignant pleural effusion (MPE) and high-risk tumors according to the LENT Score Study. METHODS: Data was collected from our database between January 2013 and December of 2015 of patients high-risk tumors according to the LENT Score and MPE. MPE was characterized as circumstances with malignant cells in pleural fluid, those with pleural infiltration recognized in the pathological evaluation or in patients with metastatic cancer at other locations validated by the pathological analyze and pleural effusion with no additional diagnosed causes after the review by the clinical team. Recurrence was defined as the need for a new pleural procedureAll patients were followed-up at least 30 days after the pleural procedure. We studied radiological aspects, biochemical and hematimetric parameters beyond clinical features. To analyze 30-day mortality, patients were divided into two groups. The first group included patients who had died up to 30 days after the palliative procedure, and the second group included patients who survived for more than 30 days after the palliative procedure. Prognostic factors for pleural recurrence and 30-day mortality were identified by univariate analysis, using Fisher's exact. Subsequently, the significant variables were entered into a multivariate logistic regression analysis (p < 0.05). RESULTS: A total of 134 patients were included in the analysis. Median follow-up time for surviving patients was 56 (range 2 to 623) days. High-risk primary tumors included lung 66,4%, gastrointestinal 24,6% , sarcoma 3,7%, urologicals 3,7% and others 1,5%. There were 44 patients in Group II and overall 22 patients had recurrence. Factors affecting 30-day mortality in univariate analysis were: procedure, Eastern Cooperative Oncology Group (ECOG), albumin, leukocytes, neutrophil to lymphocyte ratio (NRL) e hemoglobin in peripheral blood. Factors affecting recurrence were: procedures, systemic treatment, albumin and platelets. At the multivariate analysis, the type of procedure (therapeutic pleural aspiration – TPA) (p = 0.011), ECOG 3 e 4 (p = 0.004), NLR > 5 (p = 0.037) and leukocytes > 8000 (p = 0.042) were identified as independents predictors of 30-day mortality. About recurrence, only systemic treatment further than first line (p = 0.042) was identified as independent predictor. CONCLUSIONS: Patients with MPE who underwent TPA, ECOG 3 and 4, with leukocytes > 8000, NLR > 5 were significantly associated with 30-day mortality, and systemic treatment greater than first line was associated with recurrence. CLINICAL IMPLICATIONS: Recurrence and early mortality of patients with MPE varies greatly and given the invasive nature of the treatment options available, The identification of those prognostic factors may assist the choice of the optimal palliative technique. DISCLOSURES: No relevant relationships by Fernando Abrao, source=Web Response No relevant relationships by Antonio Flávio Bina Biazzotto, source=Web Response No relevant relationships by Mariana Campello de Oliveira, source=Web Response No relevant relationships by Igor Renato Louro Bruno de Abreu, source=Web Response No relevant relationships by Geisa Viana, source=Web Response