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.

Purpose: To determine the prognostic value of pleural fluid pH, pleural fluid glucose, extent of pleural carcinomatosis (EPC) score, and Karnofsky Performance Scale (KPS) score in patients with recurrent symptomatic malignant pleural effusions.Design: Prospective 53-month study.Setting: Referral cen...

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Published in:CHEST Vol. 117; no. 1; pp. 73 - 79
Main Authors: Burrows, C M, Mathews, W C, Colt, H G
Format: research Journal Article
Published: American College of Chest Physicians 2000 Jan
Online Access:View this record in EBSCOhost
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      dt: 2000 Jan
      vid: 117
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      pub: American College of Chest Physicians
      place: Glenview, Illinois
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        136636874
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        10.1378/chest.117.1.73
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        136636874
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        atl: 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.
      aug:
        au:
          Burrows, C M
          Mathews, W C
          Colt, H G
        affil: University of California at San Diego Medical Center, San Diego, CA, USA
      sug:
        subj:
          Quality of Life
          Pleural Effusion, Malignant Mortality
          Body Fluids Metabolism
          Aged, 80 and Over
          Male
          Pleurodesis
          Aged
          Talc Administration and Dosage
          Neoplasm Recurrence, Local
          Prospective Studies
          Pleural Effusion, Malignant Metabolism
          Adult
          Thoracoscopy
          Pleural Effusion, Malignant Therapy
          Hydrogen-Ion Concentration
          Middle Age
          Human
          Karnofsky Performance Status
          Pleural Effusion, Malignant Pathology
          Glucose Metabolism
          Prognosis
          Female
          Survival
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Ferrans and Powers Quality of Life Index
          Aged, 80 & over
          Aged: 65+ years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Purpose: To determine the prognostic value of pleural fluid pH, pleural fluid glucose, extent of pleural carcinomatosis (EPC) score, and Karnofsky Performance Scale (KPS) score in patients with recurrent symptomatic malignant pleural effusions.Design: Prospective 53-month study.Setting: Referral center for interventional pulmonology.Patients: Eighty-five consecutive patients (42 men and 43 women) with recurrent symptomatic malignant pleural effusions who were referred to the interventional pulmonary service for thoracoscopic pleurodesis.Measurements: Pleural fluid pH, pleural fluid glucose, EPC score, and KPS score.Results: The KPS score was the only statistically significant predictor variable. Patients with a KPS score >/= 70 had a median survival of 395 days, as opposed to a median survival of only 34 days for patients with a KPS score </= 30. No prognostic advantage was evident when patients were categorized by pleural fluid pH, pleural fluid glucose, or EPC score.Conclusion: When assessing the prognosis of a patient with a recurrent symptomatic malignant pleural effusion, only the KPS score at the time of thoracoscopy is predictive of survival. Pleural fluid pH, pleural fluid glucose, and EPC scores are not as reliable as initially reported. For patients with a KPS score >/= 70, it may be very reasonable to proceed with thoracoscopic talc pleurodesis for management of their malignant pleural effusions.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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