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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2015

01-11-2015 | Thoracic Oncology

Prognostic Factors of 30-Day Mortality After Palliative Procedures in Patients with Malignant Pleural Effusion

Authors: Fernando Conrado Abrao, MD, Igor Renato Louro Bruno de Abreu, MD, Mariana Fogarolli, MD, Giovanna Caxeiro, MD, Camila Borges Saes Bezerra, MD, Fernanda Prado de Cerqueira Cesar, MD, Poline Spitti Rocha, MD, Riad Naim Younes, PhD

Published in: Annals of Surgical Oncology | Issue 12/2015

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Abstract

Background

The aim of this study was to identify predictors of 30-day mortality in patients with malignant pleural effusion (MPE) who need pleural palliative procedures.

Methods

Data was prospectively collected from our database, between January 2013 and July 2014 on 86 patients with MPE and complete follow-up 30 days after the procedure. The sample was divided into two groups. The first group (G1) included patients who had died up to 30 days after the palliative procedure, and the second group (G2) included patients who survived for more than 30 days after the palliative procedure. The identification of prognostic factors occurred through univariate analysis using Fisher exact test for analysis of categorical variables and the t test for quantitative variables. Subsequently, all variables were used in the multivariate logistic regression analysis. The cutoff values for any significant continuous variables were determined by receiver operating characteristics analysis.

Results

There were 24 patients in G1 and 62 patients in G2. Univariate analysis of factors affecting postprocedural survival disclosed nine factors that were associated with significantly reduced postoperative survival. At the multivariate analysis, high levels of white blood cells, (p = .013), low levels of red blood cells (p < .0001) and protein in pleural fluid (p = .001), and primary lung and gastrointestinal sites (p = .0076) were identified as independent predictors of mortality.

Conclusions

We identified four factors that are easily recognized in daily practice and can help select patients with low life expectancy. Therefore, invasive procedures and hospitalizations for this subgroup of patients can be prevented.
Literature
1.
The American Thoracic Society. Management of malignant pleural effusions. Am J Respir Crit Care Med. 2000;162:1987–2001.CrossRef
2.
Cancer Statistics Registrations, England (Series MB1): Office of National Statistics, Stationary Office, 2010.
3.
Antunes G, Neville E, Duffy J, Ali N; Pleural Diseases Group, Standards of Care Committee, British Thoracic Society. BTS guidelines for the management of malignant pleural effusions. Thorax. 2003;58(suppl II):29–38.CrossRef
4.
Antony VB, Loddenkemper R, Astoul P, et al. Management of malignant pleural effusions. Eur Respir J. 2001;18:402–19.CrossRefPubMed
5.
Roberts ME, Neville E, Berrisford RG, Antunes G, Ali NJ; BTS Pleural Disease Guideline Group. Management of a malignant pleural effusion: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010;65(Suppl 2):32–40.CrossRef
6.
Tan C, Sedrakyan A, Browne J, Swift S, Treasure T. The evidence on the effectiveness of management for malignant pleural effusion: a systematic review. Eur J Cardiothorac Surg. 2006;29:829–38.CrossRefPubMed
7.
Pilling JE, Dusmet ME, Ladas G, Goldstraw P. Prognostic factors for survival after surgical palliation of malignant pleural effusion. J Thorac Oncol. 2010;5:1544–50.CrossRefPubMed
8.
Bielsa S, Salud A, Martinez M, et al. Prognostic significance of pleural fluid data in patients with malignant effusion. Eur J Intern Med. 2008;19:334–9.CrossRefPubMed
9.
Burrows CM, Mathews WC, Colt HG. Predicting survival in patients with recurrent symptomatic malignant pleural effusions: an assessment of the prognostic values of physiologic, morphologic, and quality of life measures of extent of disease. Chest. 2000;117:73–8.CrossRefPubMed
10.
Pinato DJ, Mauri FA, Ramakrishnan R, Wahab L, Lloyd T, Sharma R. Inflammation-based prognostic indices in malignant pleural mesothelioma. J Thorac Oncol. 2012;7:587–94.CrossRefPubMed
11.
Proctor MJ, Morrison DS, Talwar D, et al. A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study. Eur J Cancer. 2011;47:2633–41.CrossRefPubMed
12.
Kao SC, Pavlakis N, Harvie R, et al. High blood neutrophil-to-lymphocyte ratio is an indicator of poor prognosis in malignant mesothelioma patients undergoing systemic therapy. Clin Cancer Res. 2010;16:5805–13.CrossRefPubMed
13.
Özyurtkan MO, Balci AE, Cakmak M. Predictors of mortality within three months in the patients with malignant pleural effusion. Eur J Intern Med. 2010;21:30–4.CrossRefPubMed
14.
Anevlavis S, Kouliatsis G, Sotiriou I, et al. Prognostic factors in patients presenting with pleural effusion revealing malignancy. Respiration. 2014;87:311–6.CrossRefPubMed
15.
Al Murri AM, Bartlett JM, Canney PA, Doughty JC, Wilson C, McMillan DC. Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer. Br J Cancer. 2006;94:227–30.CrossRefPubMed
16.
Li MX, Liu XM, Zhang XF, et al. Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: a systematic review and meta-analysis. Int J Cancer. 2014;134:2403–13.CrossRefPubMed
17.
Clive OA, Kahan CB, Hooper CE, et al. Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score. Thorax. 2014;69:1098–104.PubMedCentralCrossRefPubMed
18.
Sánchez-Muñoz A, Pérez-Ruiz E, Sáez MI, et al. Limited impact of palliative chemotherapy on survival in advanced solid tumors in patients with poor performance status. Clin Transl Oncol. 2011;13:426–9.CrossRefPubMed
19.
Dresler CM, Olak J, Herndon JE II, et al. Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion. Chest. 2005;127:909–15.CrossRefPubMed
Metadata
Title
Prognostic Factors of 30-Day Mortality After Palliative Procedures in Patients with Malignant Pleural Effusion
Authors
Fernando Conrado Abrao, MD
Igor Renato Louro Bruno de Abreu, MD
Mariana Fogarolli, MD
Giovanna Caxeiro, MD
Camila Borges Saes Bezerra, MD
Fernanda Prado de Cerqueira Cesar, MD
Poline Spitti Rocha, MD
Riad Naim Younes, PhD
Publication date
01-11-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 12/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4491-6

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