Surgical Management of Metastatic Peritoneal or Pleural Disease

Do concomitant ascites influence the effectiveness of palliative surgical management of pleural effusion in patients with malignancies?

BACKGROUND

Both pleural and peritoneal effusions are associated with dismal prognosis for patients with malignancies. Pleural effusion often requires surgical palliative management to relieve symptoms. The aim of this study was assess the influence of concomitancy of ascites on the success rate of surgical management of pleural effusion in patients with solid malignancies.

METHODS

We retrospectively identified 33 patients with different primary malignancies, who underwent palliative surgical treatment for pleural effusion with concomitant ascites. The success rate of pleural effusion management was compared to that of a control group of patients with pleural effusion without ascites.

RESULTS

Ovarian and breast cancer were the most common primary sites in the group of patients with pleural and peritoneal effusions. Thoracocentesis was performed in 30 patients with concomitant ascites and in 29 patients without ascites. The median number of thoracocentesis procedures was two in both groups of patients. Talc pleurodesis was performed in 57.6 and 63.3% of patients with and without ascites, respectively. The success rate of pleurodesis was 68.4 and 71.9% for patients with and without concomitant ascites (P = 0.92), respectively. There was no significant difference in the median length of time of the chest tube placement between the two groups (with ascites, 6 days; without ascites, 5 days, P = 0.38). The overall survival was 5.6 months for patients with ascites and 7.8 months for patients without ascites (P = 0.51).

CONCLUSION

Our results suggest that concomitant ascites did not influence the effectiveness of palliative surgical management of pleural effusion in patients with malignancies.