ERS/EACTS statement on the management of malignant pleural effusions

被引:82
作者
Bibby, Anna C. [1 ,2 ]
Dorn, Patrick [3 ]
Psallidas, Ioannis [4 ]
Porcel, Jose M. [5 ]
Janssen, Julius [6 ]
Froudarakis, Marios [7 ]
Subotic, Dragan [8 ]
Astoul, Phillippe [9 ]
Licht, Peter [10 ]
Schmid, Ralph [3 ]
Scherpereel, Arnaud [11 ]
Rahman, Najib M. [4 ,12 ]
Maskell, Nick A. [1 ,2 ]
Cardillo, Giuseppe [13 ]
机构
[1] Univ Bristol, Med Sch Translat Hlth Sci, Acad Resp Unit, Bristol, Avon, England
[2] North Bristol NHS Trust, North Bristol Lung Ctr, Bristol, Avon, England
[3] Univ Hosp Bern, Div Thorac Surg, Bern, Switzerland
[4] Univ Oxford, Oxford Resp Trials Unit, Oxford, England
[5] Arnau Vilanova Univ Hosp, IRB Lleida, Pleural Med Unit, Lleida, Spain
[6] Canisius Wilhelmina Hosp, Dept Pulm Dis, Nijmegen, Netherlands
[7] Democritus Univ Thrace, Med Sch Alexandroupolis, Dept Resp Med, Alexandroupolis, Greece
[8] Clin Ctr Serbia, Clin Thorac Surg, Belgrade, Serbia
[9] Hosp North Aix Marseille Univ, Dept Thorac Oncol Pleural Dis & Intervent Pulmono, Marseille, France
[10] Odense Univ Hosp, Dept Cardiothorac Surg, Odense, Denmark
[11] Hosp Univ, CHU Lille, Pulm & Thorac Oncol Dept, Lille, France
[12] NHS Fdn Trust, Univ Hosp, Oxford Ctr Resp Med, Oxford, England
[13] Azienda Osped San Camillo Forlanini, Dept Thorac Surg, Carlo Forlanini Hosp, Rome, Italy
关键词
CELL LUNG-CANCER; QUALITY-OF-LIFE; ASSISTED THORACOSCOPIC PLEURECTOMY; RANDOMIZED CONTROLLED-TRIAL; TO-LYMPHOCYTE RATIO; TALC PLEURODESIS; PROGNOSTIC-FACTORS; THORACIC-SURGERY; CHEST-TUBE; INTRAPLEURAL STREPTOKINASE;
D O I
10.1093/ejcts/ezy258
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Malignant pleural effusions (MPE) are a common pathology, treated by respiratory physicians and thoracic surgeons alike. In recent years, several well-designed randomized clinical trials have been published that have changed the landscape of MPE management. The European Respiratory Society (ERS) and the European Association for Cardio-Thoracic Surgery (EACTS) established a multidisciplinary collaboration of clinicians with expertise in the management of MPE with the aim of producing a comprehensive review of the scientific literature. Six areas of interest were identified, including the optimum management of symptomatic MPE, management of trapped lung in MPE, management of loculated MPE, prognostic factors in MPE, whether there is a role for oncological therapies prior to intervention for MPE and whether a histological diagnosis is always required in MPE. The literature revealed that talc pleurodesis and indwelling pleural catheters effectively manage the symptoms of MPE. There was limited evidence regarding the management of trapped lung or loculated MPE. The LENT score was identified as a validated tool for predicting survival in MPE, with Brims' prognostic score demonstrating utility in mesothelioma prognostication. There was no evidence to support the use of oncological therapies as an alternative to MPE drainage, and the literature supported the use of tissue biopsy as the gold standard for diagnosis and treatment planning. Management options for malignant pleural effusions have advanced over the past decade, with high-quality randomized trial evidence informing practice in many areas. However, uncertainties remain and further research is required http://ow.ly/rNt730jOxOS
引用
收藏
页码:116 / 132
页数:17
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