Efficacy of talc pleurodesis in patients with malignant pleural effusions

The aim of this study was to analyze complications and survival after talc pleurodesis for recurrent malignant pleural effusion. Methods: All patients with proven malignant pleural effusion who received talc pleurodesis from January 2004 to August 2010 were included in a retrospective analysis. Talc pleurodesis was performed with talc slurry if the pleural effusion was known previously as neoplastic or under medical thoracoscopic with talc poudrage if the pleural effusion was undiagnosed at this moment. The procedure was performed only if a pulmonary reexpansion was proved in the previous day. Postoperative pleural drainage was used until fluid output was less than 100 ml/24 h. Results: 54 patients (30 male and 24 female) with mean age 65.9±12.5 (range 36-91) years were included. The most common primary cancer sites were lung (13 cases), mesothelioma (9), gynecological (7), digestive (8), and unknown primary (9). Six patients (11%) developed thrombosis (four in the cava vein), Two patients developed empiema and other two bronchopleural fistula. In 7 cases pleurodesis was ineffective and in nine cases pleural effusion relapsed. In 17 cases was complete success (32%) and in 21 partial success (39%). Patients with Karfnosfky index (KI) > 60% had greater survival [10.71 months 95%CI (7.34 -14.08)] than patients with KI less than 60% [2.52 months 95%CI (0.20 -4.84)] KI more than 60% is a useful criteria to select candidates to talc pleurodesis.