Semin Respir Crit Care Med 2018; 39(06): 704-712
DOI: 10.1055/s-0038-1676572
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Malignant Pleural Effusions: Management Options

David J. McCracken
1   Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, United Kingdom
2   Oxford Respiratory Trials Unit, Oxford, United Kingdom
,
Jose M. Porcel
3   Pleural Medicine Unit, Arnau de Vilanova University Hospital, IRBLleida, Lleida, Spain
,
Najib M. Rahman
1   Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, United Kingdom
2   Oxford Respiratory Trials Unit, Oxford, United Kingdom
4   Oxford NIHR Biomedical Research Centre, Oxford, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
14 January 2019 (online)

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Abstract

Malignant pleural effusion (MPE) represents advanced metastatic malignancy and is associated with poor median survival. Incidence remains high and continues to rise, in part due to changing population demographics. This therefore represents a significant health care burden. Management is predominantly palliative in nature and multiple interventions are available within conventional treatment paradigms, all of which are proven to result in statistically significant patient benefit. This article further explores the methods available in the management of MPE along with the pitfalls, complications, and alternatives. Recent advances within the field are discussed with an exploration of likely future directions, including the role of ultrasound as a prospective predictor and the role of intrapleural fibrinolytic therapy.