Predictive parameters of survival in malignant pleural effusion

Introduction: Malignant pleural effusions (MPE) have a limited survival (SV). Useful variables have been described: LDH level in PE, ECOG (0-4), Neutrophil/lymphocyte serum and histological type, generating the LENT score, which presents methodological limitations related to morbidity and pathology parameters outside the pleural space. It could be interesting for the management of these patients to analyze the influence of pleural parameters associated with SV. Methods: From 1994 to October 2014, 2879 consecutive PE have been included in Pleura Unit database. Inclusion criteria: cyto-histological confirmation of malignancy, tumor origin (T.O.), SV (measured in months) until death or loss of medical follows up and pleural study. 322 patients with MPE were included and applied statistical analysis: descriptive, mean, standard deviation (SD), probability (p), SV by Kaplan-Meier. Results: The median SV according to T.O. lung, breast, hematological, gynecological and gastrointestinal: 5,5; 17,9; 7,4; 53,4 and 1 respectively. SV according to volume: 0-25%= 8,9 +/- 2,2; 25-50%= 4,9 +/- 8,8; 50-75%= 7,98 +/- 2,58 and >75%= 0,953 +/- 0,26. p= 0,002. Pleural cholesterol (Pchol) is associated with SV as continuous variable (Cv) and dichotomic. p= 0,001 and pleural ADA as Cv (a higher level of ADA worst SV) p= 0,02. High neutrophils (N) were associated with worse SV. p= 0,000. High lymphocytes (L) were associated with better SV as Cv and dichotomic. p= 0,025. Conclusions: The tumor origin of the most frequent MPE: Lu, B, Haem, Gyn and G. PE parameters that showed statistically significant association with survival: T.O, volume of PE, Pchol, ADA, N and L in pleural effusion. The pH and pleural LDH showed no association with survival.