Chapter 14

Management of Malignant Pleural Effusion

Rosmadi Ismail, Abdul Aziz Marwan and Jamalul Azizi Abdul Rahaman

Abstract

Malignant pleural effusion (MPE) is common and the management options available for MPE are often limited. The key goal in the management of MPE is to relieve patient’s symptoms with the least invasive means and in the most cost-effective manner. The approach to the management of MPE should be tailored according to patient’s overall prognosis, symptoms, functional status, social support, treatment availability, and financial situation. Pleurodesis has been the standard of care for the management of MPE for years and talc continues to be the most effective sclerosant available for pleurodesis in MPE. However, it is also associated with more invasive procedure and longer hospitalization. Most clinical studies on MPE treatments in the past were focused on the creation of successful pleurodesis in an attempt to stop reaccumulation of pleural fluid rather than patient-related outcome measures (PROM). The current trend of incorporating indwelling pleural catheter (IPC) in the management of MPE has been shown to be as equally effective as talc pleurodesis with significantly fewer hospitalization days and may be less costly compared to pleurodesis .

Total Pages: 230-275 (46)

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