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

<p><strong>Objectives</strong>: 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 outcom...

Full description

Bibliographic Details
Main Authors: Hassan, M, Gadallah, M, Mercer, RM, Harriss, E, Rahman, NM
Format: Journal article
Language:English
Published: Taylor and Francis 2020
_version_ 1797080520449851392
author Hassan, M
Gadallah, M
Mercer, RM
Harriss, E
Rahman, NM
author_facet Hassan, M
Gadallah, M
Mercer, RM
Harriss, E
Rahman, NM
author_sort Hassan, M
collection OXFORD
description <p><strong>Objectives</strong>: 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.</p> <p><strong>Methods</strong>: 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 All study types reporting previously unpublished data on predictors of pleurodesis success were included.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.</p> <p><strong>Results</strong>: 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.</p> <p><strong>Conclusion</strong>: Overall, available results are difficult to interpret due to evidence quality. Prospective studies are needed to further explore these factors.</p> <p><strong>Protocol registration</strong>: CRD42018115874 (Prospero database of systematic reviews)</p>
first_indexed 2024-03-07T01:01:17Z
format Journal article
id oxford-uuid:89d3b7f3-baf0-4b00-b3e3-8dddad5bf27f
institution University of Oxford
language English
last_indexed 2024-03-07T01:01:17Z
publishDate 2020
publisher Taylor and Francis
record_format dspace
spelling oxford-uuid:89d3b7f3-baf0-4b00-b3e3-8dddad5bf27f2022-03-26T22:27:11ZPredictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:89d3b7f3-baf0-4b00-b3e3-8dddad5bf27fEnglishSymplectic ElementsTaylor and Francis2020Hassan, MGadallah, MMercer, RMHarriss, ERahman, NM<p><strong>Objectives</strong>: 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.</p> <p><strong>Methods</strong>: 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.</p> <p><strong>Results</strong>: 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.</p> <p><strong>Conclusion</strong>: Overall, available results are difficult to interpret due to evidence quality. Prospective studies are needed to further explore these factors.</p> <p><strong>Protocol registration</strong>: CRD42018115874 (Prospero database of systematic reviews)</p>
spellingShingle Hassan, M
Gadallah, M
Mercer, RM
Harriss, E
Rahman, NM
Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis
title Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis
title_full Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis
title_fullStr Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis
title_full_unstemmed Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis
title_short Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis
title_sort predictors of outcome of pleurodesis in patients with malignant pleural effusion a systematic review and meta analysis
work_keys_str_mv AT hassanm predictorsofoutcomeofpleurodesisinpatientswithmalignantpleuraleffusionasystematicreviewandmetaanalysis
AT gadallahm predictorsofoutcomeofpleurodesisinpatientswithmalignantpleuraleffusionasystematicreviewandmetaanalysis
AT mercerrm predictorsofoutcomeofpleurodesisinpatientswithmalignantpleuraleffusionasystematicreviewandmetaanalysis
AT harrisse predictorsofoutcomeofpleurodesisinpatientswithmalignantpleuraleffusionasystematicreviewandmetaanalysis
AT rahmannm predictorsofoutcomeofpleurodesisinpatientswithmalignantpleuraleffusionasystematicreviewandmetaanalysis