Liou Douglas Z, Serna-Gallegos Derek, Chan Joshua L, Borgella Jerald, Akhmerov Shah, Soukiasian Harmik J
Department of Surgery, Division of Thoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Am Surg. 2016 Oct;82(10):995-999.
Malignant pleural effusions (MPE) are commonly managed with either pleural catheter (PC) or talc pleurodesis (TP). The aim of this study was to compare survival in MPE patients treated with either PC or TP. A retrospective review of our cancer center database was performed. Patients with metastatic cancer and MPE were analyzed. Demographic and clinical data were tabulated and compared. A total of 238 patients with MPE treated by either PC or TP were included. Of these, 79 patients comprised the PC group and 159 the TP group. PC had a higher incidence of advanced disease (stage III or IV) at initial diagnosis compared with TP (70.9% vs 57.2%, P = 0.05). TP had a longer postprocedure length of stay compared with PC (7.1 vs 5.0 days, P = 0.02); however, overall length of stay was similar (9.7 vs 11.1 days, P = 0.34). Readmissions were significantly lower in TP (11.9% vs 22.8%, P = 0.04). Mean survival was higher in TP compared with PC (18.7 vs 4.1 months, P < 0.001). Patients with metastatic cancer and MPE treated with TP had significantly higher survival compared with PC. This is likely related to a greater disease burden in PC, as 70 per cent of patients in this group had stage III or IV disease on initial presentation.
恶性胸腔积液（MPE）通常采用胸腔置管（PC）或滑石粉胸膜固定术（TP）进行治疗。本研究的目的是比较接受PC或TP治疗的MPE患者的生存率。我们对癌症中心数据库进行了回顾性分析。对患有转移性癌症和MPE的患者进行了分析。将人口统计学和临床数据制成表格并进行比较。共有238例接受PC或TP治疗的MPE患者被纳入研究。其中，79例患者组成PC组，159例组成TP组。与TP相比，PC在初诊时晚期疾病（III期或IV期）的发生率更高（70.9%对57.2%，P = 0.05）。与PC相比，TP术后住院时间更长（7.1天对5.0天，P = 0.02）；然而，总住院时间相似（9.7天对11.1天，P = 0.34）。TP组的再入院率显著更低（11.9%对22.8%，P = 0.04）。TP组的平均生存期高于PC组（18.7个月对4.1个月，P < 0.001）。接受TP治疗的转移性癌症和MPE患者的生存率显著高于PC组。这可能与PC组更大的疾病负担有关，因为该组70%的患者在初次就诊时为III期或IV期疾病。
