Abstract
BackgroundIndwelling pleural catheters (IPC) are increasingly becoming a first-line treatment in the management of malignant pleural effusions. Ambulatory management using IPC are increasingly used in this patient group whilst they are receiving concurrent chemotherapy. There are currently no prospective trials examining IPC safety in chemotherapy. This study’s objective is to determine if IPC insertion is safe in patients undergoing chemotherapy.MethodsWe conducted a retrospective analysis of all patients who underwent IPC insertion for malignant pleural effusion at our trust from September 2010 to December 2014. Data was collected on IPC insertion and removal, tumour type, systemic chemotherapy, pleural infection and other complications.ResultsOne hundred four patients were identified, 43 in chemotherapy group and 61 in non-chemotherapy group. The incidence of pleural infection in chemotherapy group vs non-chemotherapy group, 4 (9.3 %) vs 3 (4.9 %) respectively, was not statistically different (Fisher’s exact p = 0.311). There was no significant difference in six-month infection-free duration from the date of IPC insertion (log rank p = 0.394). Overall six-month mortality in chemotherapy group was significantly lower than in non-chemotherapy group (log rank p = 0.007).ConclusionsThis is the second largest retrospective case–control series that concludes systemic chemotherapy is safe in patients with IPC undergoing chemotherapy.
Highlights
Indwelling pleural catheters (IPC) are increasingly becoming a first-line treatment in the management of malignant pleural effusions
Data collection was conducted over the period of April to July 2015, on date of IPC insertion and removal, tumour type, chemotherapy, six-month incidence of pleural infection and other complication rates, as well as six-month mortality from date of IPC insertion
The complication rate of these devices is low with no significant difference in adverse events with IPC compared to chest drain insertion and talc pleurodesis [4]
Summary
Indwelling pleural catheters (IPC) are increasingly becoming a first-line treatment in the management of malignant pleural effusions. Ambulatory management using IPC are increasingly used in this patient group whilst they are receiving concurrent chemotherapy. This study’s objective is to determine if IPC insertion is safe in patients undergoing chemotherapy. Malignant pleural effusions (MPE) are a common presentation in the advanced and disseminated stages of malignancy, complicating nearly 50 % of all lung and breast cancers [1]. MPE is associated with a poor prognosis, dependent on the type and stage of cancer, with a median survival of only 74 days in lung cancer and less than 50 days in urological cancer, sarcoma and melanoma groups [3]. A definitive single pleural intervention is important in a patient group with a poor prognosis
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