Predictors of successful pleurodesis after indwelling pleural catheter (IPC) insertions and its complications in patients with malignant pleural effusion
A. Navasakulpong*a (Dr), P. Wattanasitb (Dr)
a Prince of Songkla university, Hatyai, THAILAND ; b Prince of Songkla university, Hat Yai, THAILAND
* navasakulpong@hotmail.com
Introduction: Indwelling pleural catheter is now recommended as a treatment option for patients with symptomatic pleural effusion. IPC related complications were considered low rate and manageable. Successful pleurodesis after IPC insertion were also consistently reported. However, data regarding IPC outcomes in developing country where less cancer treatment could be accessible is still limited.
Methods: A single-center observational study was done. Data collection regarding IPC related outcomes in patients with symptomatic malignant pleural effusion, predictors of successful pleurodesis leading to IPC removal and prognostic factors for IPC related complications were evaluated using a multistate model analysis.
Results: A total of 89 patients with symptomatic malignant pleural effusion underwent IPC insertion during 2004 through 2021. Most of the patients had lung cancer (67.4%), followed by breast cancer and gynecologic malignancy (11.2% and 9.0%, respectively). Successful pleurodesis lead to IPC removal rate was 25.8%. Median time to IPC removal was 133 days. Expandable lung, talc via IPC on insertion day, and chemical pleurodesis via IPC were associated with high probability of IPC removal. Pleural infections rate was 13.6% with one case of empyema thoracis. Median time to complications was 5 weeks. Protective factor for IPC related complication was expandable lung.
Conclusion: IPC is a safe therapeutic option in patients with symptomatic malignant pleural effusion and can lead to successful pleurodesis. Expandable lung, talc via IPC on insertion day, and chemical pleurodesis via IPC were associated with higher probability of successful IPC removal. Trapped lung was a predictor of IPC related complication.
Disclosure of funding source(s): none