Pleural Fluid Resolution Is Associated with Improved Survival in Patients with Malignant Pleural Effusion
Malignant pleural effusion is associated with a poor prognosis and, while risk stratification models exist, prior studies have not evaluated pleural fluid resolution and its association with survival. We performed a retrospective review of patients diagnosed with malignant pleural effusion between 2...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/13/5/1163 |
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| author | Christina R. MacRosty Amber Wright Agathe Ceppe Sohini Ghosh A. Cole Burks Jason A. Akulian |
| author_facet | Christina R. MacRosty Amber Wright Agathe Ceppe Sohini Ghosh A. Cole Burks Jason A. Akulian |
| author_sort | Christina R. MacRosty |
| collection | DOAJ |
| description | Malignant pleural effusion is associated with a poor prognosis and, while risk stratification models exist, prior studies have not evaluated pleural fluid resolution and its association with survival. We performed a retrospective review of patients diagnosed with malignant pleural effusion between 2013 and 2017, evaluating patient demographics, pleural fluid and serum composition, and procedural and treatment data using Cox regression analysis to evaluate associations with survival. In total, 123 patients were included in the study, with median survival from diagnosis being 4.8 months. Resolution of malignant pleural fluid was associated with a significant survival benefit, even when accounting for factors such as placement of an indwelling pleural catheter, anti-cancer therapy, pleural fluid cytology, cancer pheno/genotypes, and pleural fluid characteristics. Elevated fluid protein, placement of an indwelling pleural catheter, and treatment with targeted or hormone therapies were associated with pleural fluid resolution. We conclude that the resolution of pleural fluid accumulation in patients with malignant pleural effusion is associated with a survival benefit possibility representing a surrogate marker for treatment of the underlying metastatic cancer. These findings support the need to better understand the mechanism of fluid resolution in patients with malignant pleural effusion as well as the tumor–immune interplay occurring with the malignant pleural space. |
| first_indexed | 2024-03-11T03:34:39Z |
| format | Article |
| id | doaj.art-a4ae536943244cc89a5edcce2544a0c1 |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-11T03:34:39Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-a4ae536943244cc89a5edcce2544a0c12023-11-18T02:09:33ZengMDPI AGLife2075-17292023-05-01135116310.3390/life13051163Pleural Fluid Resolution Is Associated with Improved Survival in Patients with Malignant Pleural EffusionChristina R. MacRosty0Amber Wright1Agathe Ceppe2Sohini Ghosh3A. Cole Burks4Jason A. Akulian5Section of Interventional Pulmonology and Pulmonary Oncology, Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USASection of Interventional Pulmonology and Pulmonary Oncology, Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USAMarsico Lung Institute/Cystic Fibrosis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USAInterventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Allegheny Health Network, Pittsburgh, PA 15222, USASection of Interventional Pulmonology and Pulmonary Oncology, Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USASection of Interventional Pulmonology and Pulmonary Oncology, Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USAMalignant pleural effusion is associated with a poor prognosis and, while risk stratification models exist, prior studies have not evaluated pleural fluid resolution and its association with survival. We performed a retrospective review of patients diagnosed with malignant pleural effusion between 2013 and 2017, evaluating patient demographics, pleural fluid and serum composition, and procedural and treatment data using Cox regression analysis to evaluate associations with survival. In total, 123 patients were included in the study, with median survival from diagnosis being 4.8 months. Resolution of malignant pleural fluid was associated with a significant survival benefit, even when accounting for factors such as placement of an indwelling pleural catheter, anti-cancer therapy, pleural fluid cytology, cancer pheno/genotypes, and pleural fluid characteristics. Elevated fluid protein, placement of an indwelling pleural catheter, and treatment with targeted or hormone therapies were associated with pleural fluid resolution. We conclude that the resolution of pleural fluid accumulation in patients with malignant pleural effusion is associated with a survival benefit possibility representing a surrogate marker for treatment of the underlying metastatic cancer. These findings support the need to better understand the mechanism of fluid resolution in patients with malignant pleural effusion as well as the tumor–immune interplay occurring with the malignant pleural space.https://www.mdpi.com/2075-1729/13/5/1163malignant pleural effusionindwelling pleural catheterspontaneous pleurodesispleural diseaseresolution of pleural effusionlung cancer |
| spellingShingle | Christina R. MacRosty Amber Wright Agathe Ceppe Sohini Ghosh A. Cole Burks Jason A. Akulian Pleural Fluid Resolution Is Associated with Improved Survival in Patients with Malignant Pleural Effusion Life malignant pleural effusion indwelling pleural catheter spontaneous pleurodesis pleural disease resolution of pleural effusion lung cancer |
| title | Pleural Fluid Resolution Is Associated with Improved Survival in Patients with Malignant Pleural Effusion |
| title_full | Pleural Fluid Resolution Is Associated with Improved Survival in Patients with Malignant Pleural Effusion |
| title_fullStr | Pleural Fluid Resolution Is Associated with Improved Survival in Patients with Malignant Pleural Effusion |
| title_full_unstemmed | Pleural Fluid Resolution Is Associated with Improved Survival in Patients with Malignant Pleural Effusion |
| title_short | Pleural Fluid Resolution Is Associated with Improved Survival in Patients with Malignant Pleural Effusion |
| title_sort | pleural fluid resolution is associated with improved survival in patients with malignant pleural effusion |
| topic | malignant pleural effusion indwelling pleural catheter spontaneous pleurodesis pleural disease resolution of pleural effusion lung cancer |
| url | https://www.mdpi.com/2075-1729/13/5/1163 |
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