Ramos-Esquivel, Allan

Background: Inconsistent results have been reported regarding mortality predictors of malignant pleural effusion (MPE). Objective: We aim to describe prognostic features of MPE in patients evaluated over 5 years in a referral center. Methods: All consecutive MPEs (confirmed by pleural cytology or biopsy) from January 2009 to July 2014 were included in this retrospective cohort study. Clinical data were collected from medical registries. Overall survival (OS) rate was calculated with Kaplan-Meier method and compared by the log-rank test. Hazard ratios (HRs) were calculated by the Cox proportional regression model. Results: A total of 110 patients were identified. Mean OS was 8.3 months (range: 25-426 days). No difference in OS was noted based on tumor type. Patients with MPE <50% had a significant better survival than those with malignant pleural effusion ≥50% (median OS: 15.7 vs 5.7 months; HR: 1.71; 95% confidence interval [CI]: 1.06-2.78; P = .0026). After adjusting for confounding variables, MPE size was independently associated with mortality (HR: 1.78; 95% CI: 1.11-2.91; P < .001). No association between glucose or pH in pleural fluid and OS was noted. Conclusion: Our study showed that MPE size, as determined by chest X-ray, is significantly associated with mortality.