Onkologie. 2023:17(1):16-21 | DOI: 10.36290/xon.2023.005

Update on diagnosis and management of malignant pleural effusions

Kristián Brat

Klinika nemocí plicních a tuberkulózy, Fakultní nemocnice Brno

Lékařská fakulta Masarykovy univerzity, Brno

International Clinical Research Center, Fakultní nemocnice u sv. Anny, Brno

Malignant pleural effusion (MPE) occurs in a significant proportion of patients with malignancy, more frequently in certain types of tumors. Diagnosis of MPE is based on imaging, but in most patients, a pleural intervention is required (thoracentesis, pleural biopsy, medical thoracoscopy or video-assisted thoracoscopy) for cytology and/or histology sampling. Management of MPE depends on the fluid volume, patient's symptoms and reaccumulation rate. Further considerations include patient´s general health condition, life expectancy and anticancer treatment options. In patients with recurrent MPE, talc pleurodesis or insertion of an indwelling pleural catheter (IPC) are recommended, with comparable efficacy and level of scientific evidence. In patients with MPE and "trapped lung", IPC placement is the treatment of choice. In the last decade, an extensive amount of scientific data regarding MPE management has been collected, resulting in improvements in the daily practice. The aim of this review is to present current trends and recommendations in the diagnosis and management of MPE in agreement with the current state of knowledge.

Keywords: malignant pleural effusion (MPE), pleurodesis, talc, indwelling pleural catheter (IPC).

Accepted: February 22, 2023; Published: March 1, 2023  Show citation