Predictors of talc slurry pleurodesis success in patients with malignant pleural effusions.

INTRODUCTION: Malignant pleural effusions are an important burden of malignant disease. Slurry talc pleurodesis remains one of the most common and effective therapeutic options. AIM: Investigate the predictive factors related with the efficacy of this technique in malignant pleural effusions. METHODS: Retrospective analysis of all pleurodesis performed during a 10-year period in a Pulmonology Unit. All demographic and clinical data were collected, including the histologic tumoral type and the biochemical, microbiological and cytological fluid features. Efficacy was defined as the lack of recurrence of pleural effusion. It was used Kaplan-Meyer analysis to estimate overall survival. RESULTS: From a total of 202 patients submitted to pleurodesis (47% men; mean age 66.9±12.02 years). Light's criteria identified 86.6% as exudates. We found 85.1% survival at 30-day post-pleurodesis, which means the therapy used has significant success. A logistic regression model applied explained that variance in post-pleurodesis events was mostly due to age and gender rather than pleural biochemical factors (X2(5)=44.648, p<0.001, R2 28.3%). CONCLUSION: This study suggests that clinical evaluation of biochemical values, bacteriological results and malignant tumor diagnosis may not be enough to predict post-pleurodesis relapse with high accuracy. Furthermore, we observed, in ten years of pleurodesis performed in our Hospital, that pleurodesis is an effective life prolonging therapy for patients that fit the criteria for this intervention.

Deciduoid pleural mesothelioma--a rare entity in a young woman.

Deciduoid Mesothelioma is a rare variant of epithelioid mesothelioma; it was initially thought that it only occurred in the peritoneum of young women and had nothing to do with asbestos exposure. However, since these early findings it has also been observed in the pleura and the pericardium, with possible association to asbestos. In general the prognosis is poor compared to epithelioid mesothelioma. 45 cases have been reported in the literature up to now, 22 of these were located in the pleural cavity. The authors describe a case of deciduoid pleural mesothelioma in a 40-year-old-woman who presented with right pleuritic chest pain, with no history of asbestos exposure, treated with chemotherapy followed by surgery and who died postoperatively.