Survival and prognostic factors in NSCLC patients with malignant pleural effusion

Abstract

<b>Introduction:</b> Lung cancer is the most common cause of the malignant pleural effusions (MPEs). For patients with NSCLC and MPEs, the median survival is only 3-4 months. In the era of targeted therapy, the association between&nbsp;NSCLC patient survival and MPEs remains unclear. <b>Objective:</b> The aims of this study were to evaluate the survival time and prognostic factors of NSCLC&nbsp;patients with MPEs with or without EGFR mutation. <b>Methods:</b> During January 2014 to December 2019,&nbsp;NSCLC patients with MPEs were collected retrospectively from electronic database at Songklanagarind hospital. Patient clinical characteristics, EGFR mutation status, EGFR-TKIs treatment, pleural procedure and survival time were analyzed. <b>Results:</b> A total of 145&nbsp;NSCLC patients with MPEs were included. A mean age was 63 years and 49% was female. Most of these patients were non-smoking (56%). Sixty three percent of patients were adenocarcinoma. The median LENT score was 3 and thirty-seven patients (25%) had LENT score of 5-7. The median survival time was not significant difference between patients with EGFR wild type and EGFR mutation. The survival time was shorter significantly in patients with LENT score 5-7 neither EGFR wild type nor EGFR mutation (759 days vs 58 days, p=0.01). The EGFR mutation patients who received EGFR-TKIs treatment had significant longer survival time than who did not received EGFR-TKIs (907 days vs 149 days, p=0.002). Pleural fluid pH and glucose were not a significant parameter in term of survival time correlation. <b>Conclusion:</b> NSCLC patients with MPEs who had LENT score 5-7 have shorter survival time and EGFR-TKIs treatment prolongs survival time in patient with EGFR mutation.