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Article: Role of early definitive management for newly diagnosed malignant pleural effusion related to lung cancer

TitleRole of early definitive management for newly diagnosed malignant pleural effusion related to lung cancer
Authors
Keywordslung cancer
malignant pleural effusion
pleural drainage
pleurodesis
thoracentesis
Issue Date2020
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/RES
Citation
Respirology, 2020, Epub 2020-04-06 How to Cite?
AbstractBackground and objective: The advent of effective anti‐cancer therapy has brought about uncertainty on the benefit of early definitive measures for newly diagnosed MPE from lung cancer. This study aims to investigate the outcomes of MPE in this setting. Methods: Lung cancer patients with MPE at first presentation to a tertiary care hospital were followed up till death or censored from 2011 to 2018. Early MPE control measures included chemical pleurodesis or IPC before or shortly after oncological treatment. Predictors of time to MPE re‐intervention were identified with Cox proportional hazard analyses. Results: Of the 509 records screened, 233 subjects were eligible. One hundred and twenty‐seven subjects received oral targeted therapy as first‐line treatment and 34 (26.8%) underwent early definitive MPE control measures. Early MPE control measures in addition to targeted therapy, as compared to targeted therapy alone, significantly reduced the subsequent need of MPE re‐intervention (23.5% vs 53.8%, P = 0.002). Similar benefits from MPE control measures were found in groups receiving systemic anti‐cancer therapy or best supportive care (0% vs 52%, P = 0.003; 18% vs 56.7%, P = 0.024, respectively). In the group with targetable mutations, both early MPE control measures (HR: 0.25, 95% CI: 0.12–0.53, P < 0.001) and the use of targeted therapy (HR: 0.22, 95% CI: 0.10–0.46, P < 0.001) were independently associated with longer time to MPE re‐interventions. Conclusion: Early MPE control measures in lung cancer has additional benefits on reducing the need and prolonging the time to MPE re‐intervention, independent of anti‐cancer therapies.
Persistent Identifierhttp://hdl.handle.net/10722/286243
ISSN
2021 Impact Factor: 6.175
2020 SCImago Journal Rankings: 1.857
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChiang, KY-
dc.contributor.authorHo, JCM-
dc.contributor.authorChong, P-
dc.contributor.authorTam, TCC-
dc.contributor.authorLam, DCL-
dc.contributor.authorIp, MSM-
dc.contributor.authorLee, YCG-
dc.contributor.authorLui, MMS-
dc.date.accessioned2020-08-31T07:01:11Z-
dc.date.available2020-08-31T07:01:11Z-
dc.date.issued2020-
dc.identifier.citationRespirology, 2020, Epub 2020-04-06-
dc.identifier.issn1323-7799-
dc.identifier.urihttp://hdl.handle.net/10722/286243-
dc.description.abstractBackground and objective: The advent of effective anti‐cancer therapy has brought about uncertainty on the benefit of early definitive measures for newly diagnosed MPE from lung cancer. This study aims to investigate the outcomes of MPE in this setting. Methods: Lung cancer patients with MPE at first presentation to a tertiary care hospital were followed up till death or censored from 2011 to 2018. Early MPE control measures included chemical pleurodesis or IPC before or shortly after oncological treatment. Predictors of time to MPE re‐intervention were identified with Cox proportional hazard analyses. Results: Of the 509 records screened, 233 subjects were eligible. One hundred and twenty‐seven subjects received oral targeted therapy as first‐line treatment and 34 (26.8%) underwent early definitive MPE control measures. Early MPE control measures in addition to targeted therapy, as compared to targeted therapy alone, significantly reduced the subsequent need of MPE re‐intervention (23.5% vs 53.8%, P = 0.002). Similar benefits from MPE control measures were found in groups receiving systemic anti‐cancer therapy or best supportive care (0% vs 52%, P = 0.003; 18% vs 56.7%, P = 0.024, respectively). In the group with targetable mutations, both early MPE control measures (HR: 0.25, 95% CI: 0.12–0.53, P < 0.001) and the use of targeted therapy (HR: 0.22, 95% CI: 0.10–0.46, P < 0.001) were independently associated with longer time to MPE re‐interventions. Conclusion: Early MPE control measures in lung cancer has additional benefits on reducing the need and prolonging the time to MPE re‐intervention, independent of anti‐cancer therapies.-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/RES-
dc.relation.ispartofRespirology-
dc.rightsPreprint This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Postprint This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectlung cancer-
dc.subjectmalignant pleural effusion-
dc.subjectpleural drainage-
dc.subjectpleurodesis-
dc.subjectthoracentesis-
dc.titleRole of early definitive management for newly diagnosed malignant pleural effusion related to lung cancer-
dc.typeArticle-
dc.identifier.emailHo, JCM: jhocm@hku.hk-
dc.identifier.emailTam, TCC: tamcct@hku.hk-
dc.identifier.emailLam, DCL: dcllam@hku.hk-
dc.identifier.emailIp, MSM: msmip@hku.hk-
dc.identifier.emailLui, MMS: drmslui@hku.hk-
dc.identifier.authorityHo, JCM=rp00258-
dc.identifier.authorityLam, DCL=rp01345-
dc.identifier.authorityIp, MSM=rp00347-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/resp.13812-
dc.identifier.pmid32249488-
dc.identifier.scopuseid_2-s2.0-85082937635-
dc.identifier.hkuros313372-
dc.identifier.volumeEpub 2020-04-06-
dc.identifier.isiWOS:000558761200001-
dc.publisher.placeAustralia-
dc.identifier.issnl1323-7799-

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