Prognosis of Cancer with Synchronous or Metachronous Malignant Pleural Effusion.

PURPOSE: Malignant pleural effusions (MPE) may either coincide with or follow the diagnosis of a primary tumor. Whether this circumstance influences prognosis has not been well substantiated.

METHODS

Retrospective review of all consecutive patients who were cared for at a Spanish university hospital during an 11-year period and received a diagnosis of MPE.

RESULTS

Of 401 patients, the MPE was the first evidence of cancer in 265 (66%), and it followed a previously diagnosed neoplasm in 136 (34%). Lung cancer predominated in the former group (131, 50%), and breast cancer in the latter (55, 40%). MPE that were the presenting manifestation of hematological and ovarian tumors had a statistically significant survival advantage as compared to those which developed in patients from a previously known cancer (respective absolute differences of 41 and 20 months; p < 0.005).

CONCLUSIONS

In hematological and ovarian malignancies, the synchronous or metachronous diagnosis of MPE may have prognostic implications.