Symptomatic malignant pleural effusion is a common clinical problem. This condition is associated with very high mortality, with life expectancy ranging from 3 to 12 months. Studies are contributing evidence on an increasing number of therapeutic options (therapeutic thoracentesis, thoracoscopic pleurodesis or thoracic drainage, indwelling pleural catheter, surgery, or a combination of these therapies). Despite the availability of therapies, the management of malignant pleural effusion is challenging and is mainly focused on the relief of symptoms. The therapy to be administered needs to be designed on a case-by-case basis considering patient’s preferences, life expectancy, tumour type, presence of a trapped lung, resources available, and experience of the treating team. At present, the management of malignant pleural effusion has evolved towards less invasive approaches based on ambulatory care. This approach spares the patient the discomfort caused by more invasive interventions and reduces the economic burden of the disease. A review was performed of the diagnosis and the different approaches to the management of malignant pleural effusion, with special emphasis on their indications, usefulness, cost-effectiveness, and complications. Further research is needed to shed light on the current matters of controversy and help establish a standardized, more effective management of this clinical problem.

中文翻译：

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恶性胸腔积液：诊断和管理

有症状的恶性胸腔积液是一个常见的临床问题。这种情况与非常高的死亡率有关，预期寿命为 3 至 12 个月。研究正在为越来越多的治疗选择（治疗性胸腔穿刺术、胸腔镜胸膜固定术或胸腔引流术、留置胸膜导管、手术或这些疗法的组合）提供证据。尽管有治疗方法，但恶性胸腔积液的管理具有挑战性，主要集中在缓解症状上。需要根据患者的偏好、预期寿命、肿瘤类型、是否存在被困肺、可用资源和治疗团队的经验，根据具体情况设计要进行的治疗。目前，恶性胸腔积液的管理已发展为基于门诊护理的侵入性较小的方法。这种方法使患者免受更多侵入性干预引起的不适，并减轻了疾病的经济负担。对诊断和治疗恶性胸腔积液的不同方法进行了审查，特别强调了它们的适应症、有效性、成本效益和并发症。需要进一步的研究来阐明当前的争议问题，并帮助建立对这一临床问题的标准化、更有效的管理。对诊断和治疗恶性胸腔积液的不同方法进行了审查，特别强调了它们的适应症、有效性、成本效益和并发症。需要进一步的研究来阐明当前的争议问题，并帮助建立对这一临床问题的标准化、更有效的管理。对诊断和治疗恶性胸腔积液的不同方法进行了审查，特别强调了它们的适应症、有效性、成本效益和并发症。需要进一步的研究来阐明当前的争议问题，并帮助建立对这一临床问题的标准化、更有效的管理。