Malignant pleural effusion: Updates in diagnosis, management and current challenges

Dinesh Narayan Addala; Nikolaos I Kanellakis; Eihab O Bedawi; Tao Dong; Najib M Rahman

doi:10.3389/fonc.2022.1053574

Malignant pleural effusion: Updates in diagnosis, management and current challenges

Front Oncol. 2022 Nov 17:12:1053574. doi: 10.3389/fonc.2022.1053574. eCollection 2022.

Authors

Dinesh Narayan Addala^{1

2}, Nikolaos I Kanellakis^{1

3

4}, Eihab O Bedawi^{2

5}, Tao Dong^{4

6}, Najib M Rahman^{1

2

3

4}

Affiliations

¹ Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
² Oxford Pleural Unit, Oxford University Hospitals, Oxford, United Kingdom.
³ Oxford Biomedical Research Centre, National Institute for Health Research, Oxford, United Kingdom.
⁴ Nuffield Department of Medicine, Medical Sciences Division, Chinese Academy of Medical Science Oxford Institute, University of Oxford, Oxford, United Kingdom.
⁵ Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.
⁶ Medical Research Council (MRC) Human Immunology Unit, Radcliffe Department of Medicine, Medical Research Council (MRC) Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.

Abstract

Malignant pleural effusion (MPE) is a common condition which often causes significant symptoms to patients and costs to healthcare systems. Over the past decade, the management of MPE has progressed enormously with large scale, randomised trials answering key questions regarding optimal diagnostic strategies and effective management strategies. Despite a number of management options, including talc pleurodesis, indwelling pleural catheters and combinations of the two, treatment for MPE remains symptom directed and centered around drainage strategy. The future goals for providing improved care for patients lies in changing the treatment paradigm from a generic pathway to personalised care, based on probability of malignancy type and survival. This article reviews the current evidence base, new discoveries and future directions in the diagnosis and management of MPE.

Keywords: indwelling pleural catheter (IPC); malignant pleural effusion (MPE); oncology; pleural; thoracoscopy (pleuroscopy).

Publication types

Review

Abstract

Publication types

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