Pleurodesis In Malignant Pleural Effusion Research Articles

Resource Use and Costs of Indwelling Pleural Catheters versus Pleurodesis for Malignant Pleural Effusions: A Population-based Study.

Rationale: Malignant pleural effusions (MPEs) are associated with significant health service use and healthcare costs, but the current evidence is limited. Objectives: To compare 12-month post-procedure: 1) health service utilization; and 2) healthcare costs after indwelling pleural catheter (IPC) insertion with at-home drainage performed by home care nursing services, versus in-hospital chemical pleurodesis. Methods: We performed a retrospective population-based study on a cohort of adults with MPEs who underwent IPC insertion or chemical pleurodesis between January 1, 2015 and December 31, 2019 using provincial health administrative data (Ontario, Canada). Patients were followed from the procedure date until death or until 12 months after the procedure. Inverse probability of treatment weighting was performed to adjust for imbalances in baseline characteristics. Differences in length of stay, readmissions, emergency department visits, home care visits, and healthcare costs were estimated using weighted regression analysis. Results: Of 5,752 included individuals, 4,432 (77%) underwent IPC insertion and 1,320 (23%) had pleurodesis. In the weighted sample, individuals who received an IPC had fewer inpatient days (12.4 d vs. 16 d; standardized mean difference, 0.229) but a higher proportion of subsequent admissions for empyema (2.7% vs. 1.1%; P = 0.0002) than those undergoing pleurodesis. Individuals with IPCs received more hours of nursing home care (41 h vs. 21.1 h; standardized mean difference, 0.671) but overall had lower average healthcare costs ($40,179 vs. $46,640 per patient; standardized mean difference, 0.177) than those receiving pleurodesis. Conclusions: IPCs with home nursing drainage are associated with reduced health resource use compared with pleurodesis in adults with MPEs, even after controlling for important baseline and clinical characteristics. Given that both procedures have similar health outcomes, our findings support the ongoing promotion of IPCs to increase outpatient management of patients with MPEs.

Comparison between Tranexamic acid and Doxycycline Pleurodesis in Malignant Pleural effusion by Medical Thoracoscopy

Comparison between Tranexamic acid and Doxycycline Pleurodesis in Malignant Pleural effusion by Medical Thoracoscopy

Medical Chest Drain Insertion-Considerations for a Pleural Service

This is an observational study of all patients requiring chest drain insertion in the respiratory unit in Christchurch Hospital from January 2015 to December 2016. We analysed patient characteristics, type of drain inserted, and the nature of pleural fluid. We report the success of fibrinolytic therapy for empyema and pleurodesis for malignant pleural effusions.

A Discriptive Study on the Efficacy of Doxycycline for Pleurodesis in Malignant Pleural Effusions

Objective: The purpose of this study was to determine the efficacy of Doxycycline for pleurodesis in cases of malignant pleural effusions. Subject and Methods; This was a descriptive case study conducted at Sheikh Zayed Hospital Rahim Yar Khan during the period of May 2021 to November 2021. In this study the diagnosed cases of malignant pleural effusion, irrespective of its type and metastasis in adult age range were included of both genders. The pleural effusion was effectively drained with appropriate chest drain. After complete drainage assessed by X ray chest PA view, 10 capsules of Doxycycline (100 mg) were diluted in 50 ml normal saline and were injected through chest drain and clamped for 24 hours. Paracetamol was given as analgesia. The drain was re opened after 24 hours and were followed by X ray chest to label for any fluid presence. Efficacy was lapelled as yes where there was no fluid on x ray and drain output was less than 50 ml. Results: In this study, there were total 40 cases of malignant pleural effusion of any type. Out of these 22 (62%) were females and 18 (34%) males. The mean age was 52.39±9.13 years. Regarding different types of CA, the most common was CA breast comprising 30 (60%) of the cases followed by lung cancer seen in 15 (30%) of cases. The efficacy of Doxycycline for pleurodesis was observed in 22 (56%) of cases. The efficacy was observed in 12 (72.73%) cases with effusion less than 1 liter with p= 0.01. There was no significant difference in terms of duration of pleural effusion where it was seen in 55% of cases with effusion more than 1 month and 60% of cases with duration less than this with p= 0.83. Conclusion: Doxycycline has shown its efficacy for pleurodesis in almost half of the cases. Keywords: Doxycycline, Pleurodesis, Fever, Pulmonology, Epidemiological

Iodopovidone pleurodesis for malignant pleural effusions: an updated systematic review and meta-analysis.

Chemical pleurodesis is an important option for palliation in malignant pleural effusion (MPE). To evaluate the status of iodopovidone for pleurodesis in MPE. We performed a systematic review of PubMed and EMBASE databases to identify studies evaluating the role of iodopovidone for pleurodesis in MPE. We calculated the pooled success rate of iodopovidone pleurodesis from observational studies and the risk ratio (RR) of successful pleurodesis (compared to other agents) from randomized controlled trials (RCTs). We pooled the data using the random-effects model. We also assessed the safety of iodopovidone. We included 26 studies (n = 1132, 15 observational, and 11 RCTs) in our review. The pooled success rate (95% confidence interval [CI]) from 15 observational studies (n = 648) was 90% (86-94). The efficacy rate of iodopovidone was similar with either tube thoracostomy or thoracoscopy. Eleven (n = 484) RCTs compared the efficacy of iodopovidone with other agents (especially bleomycin and talc). We found a similar success rate of iodopovidone compared to other agents with a pooled RR (95% CI) of 0.99 (0.91-1.08). The most frequent adverse event was chest pain. No hypo or hyperthyroidism, or visual disturbance was encountered in any study. There were no deaths attributed to iodopovidone use. Iodopovidone is a safe and effective agent for pleurodesis in the management of MPE. Further confirmation is required since the available evidence is limited by the low quality and small sample size of the included studies.

M04 Predictors and Outcomes of Pleurodesis in Malignant Pleural Effusion

Malignant Pleural Effusion (MPE) is a frequently encountered pathology for the cardiothoracic surgeon, and management of it has one of the highest mortality and failure rates of any procedure within thoracic surgery. This study sought to assess factors effecting failure and outcome of patients undergoing pleurodesis for MPE.

Pleural Space Elastance and Its Relation to Success Rates of Pleurodesis in Malignant Pleural Effusion.

BackgroundPleurodesis fails in 10%–40% of patients with recurrent malignant pleural effusions malignant pleural effusion and dyspnea. This study aimed to assess the values of pleural elastance (PEL) after the aspiration of 500 mL of pleural fluid and their relation to the pleurodesis outcome, and to compare the pleurodesis outcome with the chemical characteristics of pleural fluid.MethodsA prospective study was conducted in Kasr El-Aini Hospital, Cairo University, during the period from March 2019 to January 2020. The study population consisted of 40 patients with malignant pleural effusion. The measurement of PEL after the aspiration of 500 mL of fluid was done with “PEL 0.5” (cm H2O/L), and the characteristics of the pleural fluid were chemically and cytologically analyzed. Pleurodesis was done and the patients were evaluated one month later. The PEL values were compared with pleurodesis outcomes.ResultsAfter 4-week of follow-up, the success rate of pleurodesis was 65%. The PEL 0.5 was significantly higher in failed pleurodesis than it was in successful pleurodesis. A cutoff point of PEL 0.5 >14.5 cm H2O/L was associated with pleurodesis failure with a sensitivity and specificity of 93% and 100%, respectively. The patients with failed pleurodesis had significantly lower pH levels in fluid than those in the successful group (p<0.001).ConclusionPEL measurement was a significant predictor in differentiating between failed and successful pleurodesis. The increase in acidity of the malignant pleural fluid can be used as a predictor for pleurodesis failure in patients with malignant pleural effusion.

Outcome of ultrasound-guided, single session pleurodesis in malignant pleural effusion

BackgroundChemical pleurodesis is frequently indicated to relieve symptoms imposed by large/recurrent malignant pleural effusion (MPE). Traditionally, a drain is left in the pleural space till the cessation of fluid accumulation before pleurodesis. Chest ultrasound can detect an amount of pleural fluid as less as 50 ml and can confirm apposition of the pleural surfaces which is required for successful pleurodesis. This work assessed the efficiency and safety of ultrasound-guided, single-session pleurodesis in cases with MPE.ResultsSeventeen of the patients completed a 2-month follow-up. The technique demonstrated a high success rate (88.2%). The mean duration from the start of pleural drainage till pleurodesis was 1.65 ± 0.70 h ranging from 1 to 3 h. A duration of 2.5 h or less was statistically proposed as a cutoff value not to exceed to predict success (sensitivity 100%, specificity 100%). The mean time for total hospital stay related to pleurodesis was 9.88 ± 3.12 h (range 4–12 h). No complications attributed to the procedure were recorded. Pleural Adherence Score and Absent Sliding Score (ASS) had a highly statistically significant correlation (p value < 0.001).ConclusionsAn ultrasound-guided completion of the process of pleurodesis in a single session with a shorter duration of pleural fluid drainage and shorter hospital stay (can be done on a day-care basis) is efficient, safe, and cost-effective. This technique is strongly recommended to replace the traditional practice of keeping the indwelling pleural drain for several days waiting for the cessation of pleural fluid reaccumulation. An ultrasound-derived ASS can be used as early as day 1 and day 15 to confirm pleural adherence and to expect the outcome of pleurodesis.

Possibilities of surgical pleurodesis for malignant pleural effusion

Possibilities of surgical pleurodesis for malignant pleural effusion

Chemical pleurodesis for malignant pleural effusion: which agent is perfect?

BackgroundPleurodesis is defined as symphysis between two layers of pleura to prevent recurrence of effusion, and it is the best available treatment for recurrent effusions of incurable malignancies. An ideal agent must be highly effective, safe, inexpensive, and readily available which is yet to be identified.The aim of this study was to assess our results of medical pleurodesis, using 3 different chemical agents: bleomycin ampoules, doxycycline capsules, povidone–iodine solution, through two different routes, chest tube and small bore indwelling catheter.Over a period of 5 years, 104 patients with malignant recurrent pleural effusion underwent pleurodesis at our university hospital, using 3 different agents and two routes of delivery.ResultsFifty patients were male, patients’ age ranged from 22 to 74 years (57.55 ± 9.02). Fifty-nine patients (56.7%) had right-sided effusion, 61 patients (58.7%) had massive effusion. All patients were dyspneic. The rout of effusion drainage and sclerosing agent instillation was chest tube in 64 patients (61.5%) and small indwelling catheter in 40 patients. Forty-three patients received bleomycin, 36 patients received doxycycline, and 25 patients received povidone–iodine. The total success rate was 78.8%.ConclusionPleurodesis is a safe acceptable palliative procedure for malignant pleural effusion with not yet definite ideal agent or rout. Hence, the availability and the expense of agent are important.

Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis

ABSTRACT Objectives Pleurodesis is an important management option to palliate breathlessness in patients with malignant pleural effusion (MPE). This systematic review aimed to examine available literature for studies investigating factors that predict pleurodesis outcome. Methods The healthcare databases advanced search (HDAS) Medline and Embase in addition to Cochrane Database of Systematic Reviews were searched on for publications reporting on pleurodesis for MPE in English language. All study types reporting previously unpublished data on predictors of pleurodesis success were included. Thirty-four studies involving 4626 patients were included in the systematic review. Results The most common pleurodesis agent used was talc which was used in 27 studies. Meta-analyses demonstrated that the strongest predictors of pleurodesis success were higher pleural fluid pH, smaller volume of effusion pre-pleurodesis and full lung re-expansion post effusion drainage. Shorter duration of tube drainage, higher pleural fluid glucose, lower LDH, and lower pleural tumor burden all seem to favor pleurodesis success, but with considerable statistical heterogeneity between studies. Available data do not suggest that chest tube size affects pleurodesis outcome. Conclusion Overall, available results are difficult to interpret due to evidence quality. Prospective studies are needed to further explore these factors. Protocol registration CRD42018115874 (Prospero database of systematic reviews)

Video-assisted thoracoscopic iodopovidone pleurodesis for malignant pleural effusions in moderate to high-risk Colombian patients.

Introduction: In developing countries where talc may not be readily available, video-assisted thoracoscopic (VATS) iodopovidone pleurodesis offers an excellent alternative for the treatment of malignant pleural effusions (MPEs). Methods: This study analyzes a retrospective experience using VATS iodopovidone pleurodesis for malignant pleural effusions at a single cardiothoracic center in the capital of Colombia evaluating success according to LENT (Lactate, Eastern Cooperative Oncology Group-ECOG, Neutrophil-Lymphocyte ratio, Tumor type) scores. A total of 75 records of patients taken to VATS iodopovidone pleurodesis for MPEs were retrieved from our institutional database during a 5-year period from 2014-2019. Of these, 45 had complete clinical history data necessary to analyze both LENT scores and post-op follow-up imaging. Results: Of the 45 patients evaluated, 93.3% (42 patients) had either complete resolution of pleural effusions or partial resolution with an asymptomatic recovery within the first month post op. Chest pain was the most common postoperative complaint, which was present in 20% of patients. The mean postoperative ECOG score was 2±1.7. Patients with moderate to high-risk LENT scores had success rates of 96.7% and 92.3% respectively. Conclusion: Video-assisted thoracoscopic pleurodesis using Iodopovidone-iodine is an effective approach for MPEs. In developing countries where Iodopovidone iodine is readily available and affordable, patients may benefit from this agent with excellent results and minimal complications.

The Relationship of Amount of Pleural Fluid and Time of Pleurodesis with the Results of Pleurodesis in Malignant Pleural Effusions

The Relationship of Amount of Pleural Fluid and Time of Pleurodesis with the Results of Pleurodesis in Malignant Pleural Effusions

ES19.03 RCT's on Malignant Pleural Effusion Talc Pleurodesis Managment

This talk will focus on 2 recently completed multicentre RCT's in talc pleurodesis for malignant pleural effusions; IPC plus trial (NEJM 2018) and the TAPPS trial (in submission). A summary of these 2 trials is below: IPC Plus - Methods: Over a period of 4 years, we recruited patients with malignant pleural effusion at 18 centers in the United Kingdom. After the insertion of an indwelling pleural catheter, patients underwent drainage regularly on an outpatient basis. If there was no evi- dence of substantial lung entrapment (nonexpandable lung, in which lung expansion and pleural apposition are not possible because of visceral fibrosis or bronchial ob- struction) at 10 days, patients were randomly assigned to receive either 4 g of talc slurry or placebo through the indwelling pleural catheter on an outpatient basis. Talc or placebo was administered on a single-blind basis. Follow-up lasted for 70 days. The primary outcome was successful pleurodesis at day 35 after randomization. Results: The target of 154 patients undergoing randomization was reached after 584 patients were approached. At day 35, a total of 30 of 69 patients (43%) in the talc group had successful pleurodesis, as compared with 16 of 70 (23%) in the placebo group (hazard ratio, 2.20; 95% confidence interval, 1.23 to 3.92; P=0.008). No significant be- tween-group differences in effusion size and complexity, number of inpatient days, mortality, or number of adverse events were identified. No significant excess of blockages of the indwelling pleural catheter was noted in the talc group. Conclusions: Among patients without substantial lung entrapment, the outpatient administration of talc through an indwelling pleural catheter for the treatment of malignant pleural effusion resulted in a significantly higher chance of pleurodesis at 35 days than an indwelling catheter alone, with no deleterious effects. (Funded by Becton Dickinson; EudraCT number, 2012-000599-40.) TAPPS - Methods We recruited patients with malignant pleural effusion from 17 United Kingdom hospitals over 5 years. On an open-label basis, patients were randomly assigned to receive either 4g talc poudrage at thoracoscopy under conscious sedation, or chest tube insertion under local anesthetic followed by 4g talc slurry. Follow-up lasted for six months. The primary outcome was pleurodesis failure rate three months after randomization, defined as the need for further pleural intervention during follow-up. Secondary outcomes including mortality and cost-effectiveness were also assessed. Results The target of 330 patients was reached after 583 were approached. At three months, pleurodesis failure rate was 36/161 (22%) with poudrage and 38/159 (24%) with slurry (adjusted odds ratio (OR) 0.91, 95% confidence interval (CI) 0.54-1.55, p=0.74). No statistically significant differences were noted in any secondary outcome. Numbers of adverse events were similar between groups. Using a standard threshold, poudrage had a 36% probability of being cost-effective. Conclusions In patients with malignant pleural effusion, there appears to be no additional clinical or cost-effectiveness benefit to choosing talc poudrage at physician-led thoracoscopy over talc slurry through chest tube. (Funded by the United Kingdom National Institute for Health Research). Pleural effusion, Talc pleurodesis, Malignant pleural effusion

Pre-EDIT: A Randomized Feasibility Trial of Elastance-Directed Intrapleural Catheter or Talc Pleurodesis in Malignant Pleural Effusion

Talc slurry pleurodesis (TSP) prevents recurrence of symptomatic malignant pleural effusion (MPE) in 71%to 78%patients. Nonexpansile lung (NEL) frequently accounts for TSP failure but is often occult predrainage, impairing selection of patients. NEL is associated with high pleural elastance (PEL), but technical limitations have hampered the development of PEL as a predictive NEL marker. We performed a single-center, randomized, controlled, open-label feasibility trial of EDIT (elastance-directed indwelling pleural catheter or TSP) management, using a novel digital manometer and a new definition of high PEL. Patients with symptomatic MPE were randomized 1:1 between EDIT and standard care (TSP). EDIT involved PEL assessment during large-volume thoracentesis; patients with high PEL (maximum PEL sustained over 250mL [MaxPEL250]≥ 14.5cm H2O/L) were allocated to immediately receive an indwelling pleural catheter; the remainder underwent immediate drain placement for TSP. The primary outcome measure was recruitment feasibility, defined a priori as 30 patients over 12months. Secondary outcomes included safety, technical reliability, and the aspiration volume required to detect high PEL. The accuracy of the PEL definition for NEL was analyzed post hoc. Thirty-one patients were randomized (one allocation failure) over 12months. PEL assessment (mean duration, 33 minutes) was successful in 13 of 15 patients (87%). No directly attributable serious adverse events occurred. High PEL was detected in seven of 13 patients (54%), associated with 100%sensitivity and 67%specificity for NEL, and was first detected at a median volume of 325mL (range, 250-800mL). A phase 3 trial testing the effect of EDIT management on symptomatic MPE recurrence following TSP is feasible. ClinicalTrials.gov; No.: NCT03319186; URL: www.clinicaltrials.gov.

P3.01-73 Talc Versus Minocycline and OK-432 Pleurodesis for Malignant Pleural Effusion.

Globally, talc pleurodesis is the standard treatment for malignant pleural effusion. In Japan, a combination of minocycline (MINO) and OK-432 has been commonly used for treating pleurodesis of malignant pleural effusion; however, data comparing talc and MINO + OK-432 are insuffient. To compare the success rates and adverse events of talc and MINO + OK-432. We retrospectively assessed 73 patients receiving pleurodesis for malignant pleural effusion (lung cancer, 60; malignant mesothelioma, 3; others, 10) for the first time between January 2010 and January 2017 at our hospital. We assessed the rates of fever, pain, after drug administration and success of pleurodesis. Moreover, we assessed the difference in success rates according to the pathology of the disease or chemotherapy. Of the 73 patients, 51 were men and 22 were women, the median age was 75 years (range 47-98). The rate of fever was significantly low in the talc group, although no statistical difference was observed in the success rate (talc, 75.9%, MINO + OK-432, 85.1%), period of drainage tube insertion (3.2 and 3.6 days) and the rate of pain (30% and 50%). No statistical difference according to the pathology of the disease or chemotherapy was observed. Thus, we can perform pleurodesis in patients with talc less invasively than with MINO + OK-432.

Sonographic evaluation of different sclerosing agents in pleurodesis of malignant pleural effusion at Zagazig University Hospitals

Background Malignant pleural effusion (MPE) arises in advanced stages of malignancies and frequently carries a poor prognosis. The most common management of the patients with refractory MPE is pleurodesis. Ultrasound is easy, bedside, cheap, and an accurate method to detect successful pleurodesis by using the pleural sliding sign due to movement of parietal pleura on visceral pleura. Aim To detect the efficacy of thoracic ultrasound (TUS) assessment in patients undergoing pleurodesis for recurrent symptomatic MPE. Patients and methods The study was carried out at the Chest Department, Zagazig University Hospital from October 2016 to August 2017. It included 32 patients with recurrent MPE, four men and 24 women. They were divided into four groups according to the method of pleurodesis (tetracycline, fluorouracil, povidone–iodine, and spontaneous pleurodesis). Chest ultrasound was done before pleurodesis and 1 month after pleurodesis for assessing the presence or absence of lung sliding sign in different areas. Results The study show that TUS can be used to detect successful or failed pleurodesis by using lung sliding sign. In the tetracycline group, 12.5% of patients showed successful pleurodesis. In the fluorouracil group, 100% of patients had successful pleurodesis. In the povidone–iodine group, 75% of patients had successful pleurodesis. In spontaneous pleurodesis 50% of patients had successful pleurodesis. Conclusion TUS is an easy and accurate method for the detection of successful pleurodesis. Fluorouracil and povidone–iodine carry better prognosis than tetracycline and spontaneous pleurodesis.

Doxycycline poudrage in pleurodesis of malignant pleural effusion: a novel modality for an old agent

ContextMalignant pleural effusion is a common presentation of several malignancies. Chemical pleurodesis is important in its management, but no consensus exists on the optimal agent or methods of pleurodesis.AimThis work aimed to evaluate the outcome of oral doxycycline capsules in a poudrage form through a medical thoracoscope as a therapeutic approach for pleurodesis in patients with malignant pleural effusion.Setting and designThis study was a prospective quasiexperimental one.Patients and methodsThis prospective quasiexperimental study was conducted on 70 patients with metastatic pleural effusion. They underwent pleurodesis with thoracoscopic doxycycline poudrage.ResultsThe success of doxycycline powder poudrage was complete in 75.7% of cases and partial in 10% of cases; however, failure was observed in 14.3%. Thus, total success rate was 85.7%. As regards complications, they were irrelevant; pain was the predominant feature in 81.4% of cases, fever in 11.4% of cases, and empyema in only 4.3% of cases.ConclusionUsing oral doxycycline with thoracoscopic poudrage yielded a remarkable success rate and may alternate the need for talc powder with less complications and more safety.

Efficacy and Safety of Povidone-iodine Pleurodesis in Malignant Pleural Effusions.

Introduction:Malignant pleural effusion (MPE) is determined by the detection of malignant cells in pleural fluid or pleural tissue. Neoplasm of lung, breast, ovary and lymphoma are the causes of more than 75% of MPE. Pleurodesis is a usual technique in the management of MPE to achieve a symphysis between two layers of the pleura, and various chemical agents have been used in an attempt to produce pleurodesis. With regard to complications and limitations of these sclerosing agents, efficacy and safety of povidone-iodine have been investigated in this study.Materials and Methods:Between June 2014 and June 2016, 63 consecutive patients were admitted to the Department of Thoracic Surgery because of symptomatic MPE. After insertion of a chest tube, pleurodesis with instillation of povidone-iodine was performed. Thyroid and renal function tests were checked, and success rate as well as recurrence of MPE was monitored in the next follow-up visits.Results:The complete response to this procedure was about 53.57%, and failure of treatment was 10.71% with efficacy of 82.2%. The most common complication was pain during instillation (26.9%). Changes in thyroid and renal function tests were not significant.Conclusion:Povidone-iodine is a safe and effective agent with minor side effects in pleurodesis of patients with MPEs and can be used as an accessible and low-cost alternative than other sclerosing agents.

Comparison of two indwelling pleural catheter types for malignant pleural effusions.

205 Background: Indwelling pleural catheter (IPC) placement is an alternative to chemical pleurodesis for malignant pleural effusion (MPE), a complication of advanced cancer. In 1997 an IPC was approved which uses vacuum bottles (VB) for drainage (PleurX, Becton, Dickinson and Company, Franklin Lakes, NJ), and later another IPC system, which employs a manually operated vacuum pump (VP) for drainage (Aspira, Bard Access Systems, Salt Lake City, UT). Most studies comparing IPC versus chemical pleurodesis used the VB IPC. In clinical practice VB and VP are used interchangeably. We conducted a single-center retrospective study to compare the efficacy and safety of these two IPC systems. Methods: With Institutional Review Board approval, we recorded baseline characteristics and outcomes in patients with MPE who received an IPC in our hospital from January 2013 to March 2015. Results: 27 patients were found (median age 59 years, range 30-92). ECOG performance status was 3-4 in 24 (89%); mean ±SD albumin, 2.49 ± 0.48g/dL; median respiratory rate 24 breaths / minute (range 18-40); median heart rate 106 beats / minute (range 59 – 138). A palliative care consultation was requested in 14 (52%) patients. Cancer was of lung (9 patients, 33%), breast (8, 30%), gastrointestinal (4, 15%), hematological (2, 7%), gynecological (2, 7%), prostate (1, 4%) and melanoma (1, 4%). Pleural fluid was exudate in 24 (89%); cytology malignant in 8 (31%). Six patients (22%) received chemotherapy with IPC in situ. VP group (VPG) consisted of 18 (67%) patients and the VB group (VBG) of 9 (33%), with similar characteristics. Spontaneous pleurodesis and IPC removal were achieved in 4 patients (22%) in VPG, 3 (33%) in VBG. Additional pleural procedures were required in 6 (33%) of VPG and 2 (22%) of VBG. Median length of stay was 9 days (range 2 – 38) in VPG, 13 days (range 4-32) in VBG. Catheter-related complications (pain, obstruction, infection, hemorrhage) rate was 39% (7 patients) in VPG and 33% (3 patients) in VBG; no death was caused. Intergroup differences were not statistically significant. Conclusions: In our sample, symptom palliation was achieved in all patients; efficacy and safety were similar for either type of IPC. More studies are needed for further comparisons.