Anzeige
Erschienen in:
16.07.2018 | Pulmonology and Respiratory Care (D Breen, Section Editor)
Malignant Pleural Effusions—Personalised Management
Erschienen in: Current Geriatrics Reports | Ausgabe 3/2018
Einloggen, um Zugang zu erhaltenAbstract
Purpose of Review
Malignant pleural effusions (MPEs) are frequent and are associated with significant morbidity and mortality. This article reviews the most recent literature on the management of MPE.
Recent Findings
With an increasing focus on personalised medicine, the primary treatment aims have changed from the primary aim of recurrence prevention to symptom control and quality of life improvement. Dependent on patient preference, options available to achieve such targets include repeated aspiration, talc pleurodesis (either through a small-bore chest drain or at thoracoscopy), and indwelling pleural catheters (IPCs). There is a consensus regarding the use of IPC in cases of trapped lung and failed talc pleurodesis, but two recent randomised controlled trials have proposed the use of IPCs as first-line therapy.
Conclusion
MPE management should be personalised, considering factors such as predicted survival, performance status, social support, local expertise and, most importantly, patient preference. IPCs are now more widely available as a treatment option and should be explored as a first-line treatment in selected patients.