Management of malignant pleural effusion: an interpretation of 2018 ATS/STS/STR clinical practice guideline_Chinese Journal of Evidence-Based Medicine

Authors：

SHENG Yongchun , CHEN Lei ,  WEN Fuqiang

Department of Respiratory and Critical Care Medicine, Division of Pulmonary Diseases of State Key Laboratory of Biotherapy of China, West China Hospital of Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

WEN Fuqiang, Email: wenfuqiang.scu@gmail.com

Keywords：

Malignant pleural effusion; Manegement; American Thoracic Society; American Society of Thoracic Surgeons; American Society of Thoracic Ranliology; Guideline; Interpretation

DOI：

10.7507/1672-2531.201812081

Video：

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The management of malignant pleural effusion remains a clinical challenge. In November 2018, American Thoracic Society, Society of Thoracic Surgeons, and Society of Thoracic Radiology summarized the recent advances and provided 7 recommendations for clinical problems of the management of malignant pleural effusion. This paper interprets these recommendations to provide references for management and research on malignant pleural effusion.

Citation： SHENG Yongchun, CHEN Lei, WEN Fuqiang. Management of malignant pleural effusion: an interpretation of 2018 ATS/STS/STR clinical practice guideline. Chinese Journal of Evidence-Based Medicine, 2019, 19(3): 271-275. doi: 10.7507/1672-2531.201812081 Copy

1.	中国恶性胸腔积液诊断与治疗专家共识组. 恶性胸腔积液诊断与治疗专家共识. 中华内科杂志, 2014, 53(3): 252-256.
2.	Psallidas I, Kalomenidis I, Porcel JM, et al. Malignant pleural effusion: from bench to bedside. Eur Respir Rev, 2016, 25(140): 189-198.
3.	Asciak R, Rahman NM. Malignant pleural effusion: from diagnostics to therapeutics. Clin Chest Med, 2018, 39(1): 181-193.
4.	Feller-Kopman DJ, Reddy CB, DeCamp MM, et al. Management of malignant pleural effusions. An official ATS/STS/STR clinical practice guideline. Am J Respir Crit Care Med, 2018, 198(7): 839-849.
5.	Grogan DR, Irwin RS, Channick R, et al. Complications associated with thoracentesis. A prospective, randomized study comparing three different methods. Arch Intern Med, 1990, 150(4): 873-877.
6.	Gordon CE, Feller-Kopman D, Balk EM, et al. Pneumothorax following thoracentesis: a systematic review and meta-analysis. Arch Intern Med, 2010, 170(4): 332-329.
7.	Mercaldi CJ, Lanes SF. Ultrasound guidance decreases complications and improves the cost of care among patients undergoing thoracentesis and paracentesis. Chest, 2013, 143(2): 532-538.
8.	Tremblay A, Robbins S, Berthiaume L, et al. Natural history of asymptomatic pleural effusions in lung cancer patients. J Bronchology, 2007, 14(2): 98-100.
9.	Porcel JM, Gasol A, Bielsa S, et al. Clinical features and survival of lung cancer patients with pleural effusions. Respirology, 2015, 20(4): 654-659.
10.	Huggins JT, Sahn SA, Heidecker J, et al. Characteristics of trapped lung: pleural fluid analysis, manometry, and air-contrast chest CT. Chest, 2007, 131(1): 206-213.
11.	Roberts ME, Neville E, Berrisford RG, et al. Management of a malignant pleural effusion: British thoracic society pleural disease guideline 2010. Thorax, 2010, 65(Suppl 2): ii32-40.
12.	Bhatnagar R, Corcoran JP, Maldonado, et al. Advanced medical interventions in pleural disease. Eur Respir Rev, 2016, 25: 199-213.
13.	Feller-Kopman D. Therapeutic thoracentesis: the role of ultrasound and pleural manometry. Curr Opin Pulm Med, 2007, 13: 312-318.
14.	Lee HJ, Yarmus L, Kidd D, et al. Comparison of pleural pressure measuring instruments. Chest, 2014, 146(4): 1007-1012.
15.	Lan RS, Lo SK, Chuang ML, et al. Elastance of the pleural space: a predictor for the outcome of pleurodesis in patients with malignant pleural effusion. Ann Intern Med, 1997, 126(10): 768-774.
16.	Scarci M, Caruana E, Bertolaccini L, et al. Current practices in the management of malignant pleural effusions: a survey among members of the European Society of Thoracic Surgeons. Interact Cardiovasc Thorac Surg, 2017, 24(3): 414-417.
17.	Dresler CM, Olak J, Herndon JE 2nd, et al. Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion. Chest, 2005, 127(3): 909-15.
18.	Boshuizen RC, Vd Noort V, Burgers JA, et al. A randomized controlled trial comparing indwelling pleural catheters with talc pleurodesis (NVALT-14). Lung Cancer, 2017, 108: 9-14.
19.	Davies HE, Mishra EK, Kahan BC, et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial. JAMA, 2012, 307(22): 2383-2389.
20.	Demmy TL, Gu L, Burkhalter JE, et al. Optimal management of malignant pleural effusions (results of CALGB 30102). J Natl Compr Canc Netw, 2012, 10(8): 975-982.
21.	Thomas R, Fysh ETH, Smith NA, et al. Effect of an indwelling pleural catheter vs talc pleurodesis on hospitalization days in patients with malignant pleural effusion: The AMPLE Randomized Clinical Trial. JAMA, 2017, 318(19): 1903-1912.
22.	Iyer NP, Reddy CB, Wahidi MM, et al. Indwelling pleural catheter versus pleurodesis for malignant pleural effusions: a systematic review and meta-Analysis. Ann Am Thorac Soc, 2019, 16(1): 124-131.
23.	Bhatnagar R, Keenan EK, Morley AJ, et al. Outpatient talc administration by indwelling pleural catheter for malignant effusion. N Engl J Med, 2018, 378(14): 1313-1322.
24.	Clive AO, Jones HE, Bhatnagar R, et al. Interventions for the management of malignant pleural effusions: a network meta-analysis. Cochrane Database Syst Rev, 2016, (5): CD010529.
25.	Yim AP, Chan AT, Lee TW, et al. Thoracoscopic talc insufflation versus talc slurry for symptomatic malignant pleural effusion. Ann Thorac Surg, 1996, 62(6): 1655-1658.
26.	Mummadi S, Kumbam A, Hahn PY. Malignant pleural effusions and the role of talc poudrage and talc slurry: a systematic review and meta-analysis. F1000Res, 2014, 3: 254.
27.	施焕中. 理性与无奈的选择: 美国2018版恶性胸腔积液管理指南解读. 协和医学杂志, 2018, 9(6): 89-91.
28.	Ohm C, Park D, Vogen M, et al. Use of an indwelling pleural catheter compared with thorascopic talc pleurodesis in the management of malignant pleural effusions. Am Surg, 2003, 69(3): 198-202.
29.	Thornton RH, Miller Z, Covey AM, et al. Tunneled pleural catheters for treatment of recurrent malignant pleural effusion following fai led pleurodesis. J Vasc Interv Radiol, 2010, 21(5): 696-700.
30.	Putnam JB Jr, Light RW, Rodriguez RM, et al. A randomized comparison of indwelling pleural catheter and doxycycline pleurodesis in the management of malignant pleural effusions. Cancer, 1999, 86(10): 1992-1999.
31.	Fysh ETH, Waterer GW, Kendall PA, et al. Indwelling pleural catheters reduce inpatient days over pleurodesis for malignant pleural effusion. Chest, 2012, 142(2): 394-400.
32.	Fysh ETH, Tremblay A, Feller-Kopman D, et al. Clinical outcomes of indwelling pleural catheter-related pleural infections: an international multicenter study. Chest, 2013, 144(5): 1597-1602.
33.	Mahmood K, Bower C. Treatment of infection associated with tunneled pleural catheters. J Bronchology Interv Pulmonol, 2010, 17(1): 69-72.
34.	Nasreen N, Mohammed KA, Brown S, et al. Talc mediates angiostasis in malignant pleural effusions via endostatin induction. Eur Respir J, 2007, 29(4): 761-769.

1. 中国恶性胸腔积液诊断与治疗专家共识组. 恶性胸腔积液诊断与治疗专家共识. 中华内科杂志, 2014, 53(3): 252-256.
2. Psallidas I, Kalomenidis I, Porcel JM, et al. Malignant pleural effusion: from bench to bedside. Eur Respir Rev, 2016, 25(140): 189-198.
3. Asciak R, Rahman NM. Malignant pleural effusion: from diagnostics to therapeutics. Clin Chest Med, 2018, 39(1): 181-193.
4. Feller-Kopman DJ, Reddy CB, DeCamp MM, et al. Management of malignant pleural effusions. An official ATS/STS/STR clinical practice guideline. Am J Respir Crit Care Med, 2018, 198(7): 839-849.
5. Grogan DR, Irwin RS, Channick R, et al. Complications associated with thoracentesis. A prospective, randomized study comparing three different methods. Arch Intern Med, 1990, 150(4): 873-877.
6. Gordon CE, Feller-Kopman D, Balk EM, et al. Pneumothorax following thoracentesis: a systematic review and meta-analysis. Arch Intern Med, 2010, 170(4): 332-329.
7. Mercaldi CJ, Lanes SF. Ultrasound guidance decreases complications and improves the cost of care among patients undergoing thoracentesis and paracentesis. Chest, 2013, 143(2): 532-538.
8. Tremblay A, Robbins S, Berthiaume L, et al. Natural history of asymptomatic pleural effusions in lung cancer patients. J Bronchology, 2007, 14(2): 98-100.
9. Porcel JM, Gasol A, Bielsa S, et al. Clinical features and survival of lung cancer patients with pleural effusions. Respirology, 2015, 20(4): 654-659.
10. Huggins JT, Sahn SA, Heidecker J, et al. Characteristics of trapped lung: pleural fluid analysis, manometry, and air-contrast chest CT. Chest, 2007, 131(1): 206-213.
11. Roberts ME, Neville E, Berrisford RG, et al. Management of a malignant pleural effusion: British thoracic society pleural disease guideline 2010. Thorax, 2010, 65(Suppl 2): ii32-40.
12. Bhatnagar R, Corcoran JP, Maldonado, et al. Advanced medical interventions in pleural disease. Eur Respir Rev, 2016, 25: 199-213.
13. Feller-Kopman D. Therapeutic thoracentesis: the role of ultrasound and pleural manometry. Curr Opin Pulm Med, 2007, 13: 312-318.
14. Lee HJ, Yarmus L, Kidd D, et al. Comparison of pleural pressure measuring instruments. Chest, 2014, 146(4): 1007-1012.
15. Lan RS, Lo SK, Chuang ML, et al. Elastance of the pleural space: a predictor for the outcome of pleurodesis in patients with malignant pleural effusion. Ann Intern Med, 1997, 126(10): 768-774.
16. Scarci M, Caruana E, Bertolaccini L, et al. Current practices in the management of malignant pleural effusions: a survey among members of the European Society of Thoracic Surgeons. Interact Cardiovasc Thorac Surg, 2017, 24(3): 414-417.
17. Dresler CM, Olak J, Herndon JE 2nd, et al. Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion. Chest, 2005, 127(3): 909-15.
18. Boshuizen RC, Vd Noort V, Burgers JA, et al. A randomized controlled trial comparing indwelling pleural catheters with talc pleurodesis (NVALT-14). Lung Cancer, 2017, 108: 9-14.
19. Davies HE, Mishra EK, Kahan BC, et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial. JAMA, 2012, 307(22): 2383-2389.
20. Demmy TL, Gu L, Burkhalter JE, et al. Optimal management of malignant pleural effusions (results of CALGB 30102). J Natl Compr Canc Netw, 2012, 10(8): 975-982.
21. Thomas R, Fysh ETH, Smith NA, et al. Effect of an indwelling pleural catheter vs talc pleurodesis on hospitalization days in patients with malignant pleural effusion: The AMPLE Randomized Clinical Trial. JAMA, 2017, 318(19): 1903-1912.
22. Iyer NP, Reddy CB, Wahidi MM, et al. Indwelling pleural catheter versus pleurodesis for malignant pleural effusions: a systematic review and meta-Analysis. Ann Am Thorac Soc, 2019, 16(1): 124-131.
23. Bhatnagar R, Keenan EK, Morley AJ, et al. Outpatient talc administration by indwelling pleural catheter for malignant effusion. N Engl J Med, 2018, 378(14): 1313-1322.
24. Clive AO, Jones HE, Bhatnagar R, et al. Interventions for the management of malignant pleural effusions: a network meta-analysis. Cochrane Database Syst Rev, 2016, (5): CD010529.
25. Yim AP, Chan AT, Lee TW, et al. Thoracoscopic talc insufflation versus talc slurry for symptomatic malignant pleural effusion. Ann Thorac Surg, 1996, 62(6): 1655-1658.
26. Mummadi S, Kumbam A, Hahn PY. Malignant pleural effusions and the role of talc poudrage and talc slurry: a systematic review and meta-analysis. F1000Res, 2014, 3: 254.
27. 施焕中. 理性与无奈的选择: 美国2018版恶性胸腔积液管理指南解读. 协和医学杂志, 2018, 9(6): 89-91.
28. Ohm C, Park D, Vogen M, et al. Use of an indwelling pleural catheter compared with thorascopic talc pleurodesis in the management of malignant pleural effusions. Am Surg, 2003, 69(3): 198-202.
29. Thornton RH, Miller Z, Covey AM, et al. Tunneled pleural catheters for treatment of recurrent malignant pleural effusion following fai led pleurodesis. J Vasc Interv Radiol, 2010, 21(5): 696-700.
30. Putnam JB Jr, Light RW, Rodriguez RM, et al. A randomized comparison of indwelling pleural catheter and doxycycline pleurodesis in the management of malignant pleural effusions. Cancer, 1999, 86(10): 1992-1999.
31. Fysh ETH, Waterer GW, Kendall PA, et al. Indwelling pleural catheters reduce inpatient days over pleurodesis for malignant pleural effusion. Chest, 2012, 142(2): 394-400.
32. Fysh ETH, Tremblay A, Feller-Kopman D, et al. Clinical outcomes of indwelling pleural catheter-related pleural infections: an international multicenter study. Chest, 2013, 144(5): 1597-1602.
33. Mahmood K, Bower C. Treatment of infection associated with tunneled pleural catheters. J Bronchology Interv Pulmonol, 2010, 17(1): 69-72.
34. Nasreen N, Mohammed KA, Brown S, et al. Talc mediates angiostasis in malignant pleural effusions via endostatin induction. Eur Respir J, 2007, 29(4): 761-769.

Chinese Journal of Evidence-Based Medicine

Management of malignant pleural effusion: an interpretation of 2018 ATS/STS/STR clinical practice guideline

Abstract Full text Figures/Tables Video References Cited by

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