INTRODUCTION Recurrent pleural effusion is a common cause of dyspnoea, cough and chest pain during the course of malignant diseases. Chemical pleurodesis had been the only definitive treatment option until two decades ago. Indwelling pleural catheters (IPC) emerged as an alternative, not only assuring immediate symptom relief but also potentially leading to pleurodesis in the absence of sclerosing agents. METHODS In this single-centre retrospective observational study patient characteristics, procedural variables and outcome in a large population of patients with IPC in malignancy were evaluated and prognostic factors for pleurodesis were identified. RESULTS From 2006 to 2016, 395 patients received 448 IPC, of whom 121 (30.6%) had ovarian, 91 (23.0%) lung and 45 (11.4%) breast cancer. The median length of IPC remaining in place was 1.2 months (IQR, 0.5-2.6), the median survival time after insertion 2.0 months (IQR, 0.6-6.4). An adequate symptom relief was achieved in 94.9% of all patients, with no need for subsequent interventions until last visit or death. In patients surviving ≥30 days after IPC insertion, pleurodesis was observed in 44.5% and was more common in patients < 60 years (HR, 1.72; 95% CI, 1.05-2.78; p = 0.03). The use of an additional talc slurry via the IPC was highly predictive for pleurodesis (HR 6.68; 95% CI, 1.44-31.08; p = 0.02). Complications occurred in 13.4% of all procedures (n = 60), 41.8% concerning infections (local infections at the tunnel/exit site (n = 14) and empyema (n = 11)), and 98.3% being low or mild grade (n = 59). Complication rates were higher in men than women (18.6 vs. 12.4%, p = 0.023). CONCLUSION High efficacy in symptom relief and a favourable safety profile confirm IPC as suitable first line option in most malignant pleural effusions. The study presents the largest dataset on IPC in gynaecologic cancer to date. Gender-specific differences in complication rates warrant further study.

中文翻译：

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留置胸膜导管用于恶性肿瘤相关胸腔积液：报告单个中心十年的经验。

引言反复性胸腔积液是恶性疾病过程中呼吸困难，咳嗽和胸痛的常见原因。直到二十年前，化学胸膜固定术一直是唯一的确定性治疗选择。留置胸膜导管（IPC）成为一种替代选择，不仅可以确保症状立即缓解，而且在缺乏硬化剂的情况下也有可能导致胸膜固定术。方法在这项单中心回顾性观察性研究中，对大量IPC恶性肿瘤患者的程序变量和预后进行了评估，并确定了胸膜固定术的预后因素。结果2006年至2016年，共有395例患者接受了448例IPC，其中121例（30.6％）患有卵巢癌，91例（23.0％）肺癌和45例（11.4％）乳腺癌。保留的IPC的中位长度为1。2个月（IQR，0.5-2.6），插入后的中位生存时间为2.0个月（IQR，0.6-6.4）。在所有患者中，有94.9％的患者症状得到了充分缓解，直到上次就诊或死亡之前都无需进行后续干预。在IPC插入后存活≥30天的患者中，发现胸膜固定症的比例为44.5％，在60岁以下的患者中更为常见（HR，1.72； 95％CI，1.05-2.78； p = 0.03）。通过IPC使用额外的滑石浆对胸膜固定术具有很高的预测性（HR 6.68； 95％CI，1.44-31.08； p = 0.02）。并发症发生率占所有手术的13.4％（n = 60），感染占41.8％（隧道/出口部位局部感染（n = 14）和脓胸（n = 11）），低度或轻度（98.3％）（ n = 59）。男性的并发症发生率高于女性（18.6％对12.4％，p = 0.023）。结论缓解症状的高效率和良好的安全性证实了IPC是大多数恶性胸腔积液的一线治疗选择。该研究提出了迄今为止妇科癌症中IPC的最大数据集。性别差异在并发症发生率上有待进一步研究。