Clinical outcomes of video-assisted thoracoscopic surgery, talc pleurodesis and indwelling catheterisation for malignant pleural effusion: A retrospective comparative study.

INTRODUCTION

Malignant pleural effusion (MPE) is a common complication of advanced cancer that impairs quality of life. The present study compared the outcomes of three procedures: tube thoracostomy with talc pleurodesis, video-assisted thoracoscopic surgery (VATS) with talc and indwelling pleural catheter (IPC).

PATIENTS AND

METHODS

In this retrospective study, 76 MPE patients were assigned to tube + talc ( n = 29), VATS + talc ( n = 27) or IPC ( n = 20). Outcomes included pleurodesis success, complications, hospitalisation, 30-day reintervention, mortality and overall survival. Eastern Cooperative Oncology Group (ECOG) performance score and serum albumin were analysed as prognostic factors using Cox regression.

RESULTS

IPC had the shortest hospital stay (3 days) and the highest 30-day reintervention rate (20%, P = 0.030). Pleurodesis success was 84.6% in both the tube and VATS groups. Median survival differed among groups (66 days for IPC, 95 days for tube and 118 days for VATS; P = 0.041); however, procedure type was not an independent predictor of survival, and these differences should be interpreted cautiously. ECOG ≥2 (hazard ratio [HR]: 1.74, P = 0.020) and albumin <3.0 g/dL (HR: 1.60, P = 0.040) were identified as independent predictors of poorer survival.

CONCLUSION

Treatment selection should primarily be based on functional and nutritional status rather than expected survival benefit. ECOG performance status and serum albumin levels should play a central role in guiding individualised management strategies.