Analysis of Quality of Life after Pleurodesis in Patients with Malignant Pleural Effusion.


Journal

Respiration; international review of thoracic diseases
ISSN: 1423-0356
Titre abrégé: Respiration
Pays: Switzerland
ID NLM: 0137356

Informations de publication

Date de publication:
Historique:
received: 05 11 2018
accepted: 10 07 2019
pubmed: 7 11 2019
medline: 24 9 2020
entrez: 7 11 2019
Statut: ppublish

Résumé

Malignant pleural effusion is one of the most important complications of metastatic cancer, and recurrent pleural effusions do not only have an impact on survival but also cause a huge repercussion on a patient's quality of life. The main objective was to describe quality of life status before and after pleurodesis in patients with malignant pleural effusion. Secondary, we aimed to find predictors of quality of life improvement in such a population. Retrospective analysis of a database collected prospectively. We included patients who underwent pleurodesis from June 2004 to July 2014. Quality of life was evaluated through the WHOQOL-BREF questionnaire and applied before and 30 days after pleurodesis. We used a paired t test and the Wilcoxon rank-sum to compare pre-/post-pleurodesis results, Kaplan-Meier curves for survival analysis, and multiple linear regressions to find predictors of quality of life improvement. 183 patients were included (145 were women). Mean age was 58.3 ± 12.3 years, the most numerous primary tumor was breast cancer. Median survival time was 9 months. Dyspnea was the most prevalent symptom. Baseline results showed that patients had low quality of life scores. After pleurodesis, there was a significant improvement in respiratory symptoms, physical domain, and general health. Linear regression showed an improvement in physical domain with the sclerosing agent nitrate (p = 0.005). Male gender (p = 0.002) and a higher lymphocyte count (p = 0.01) were inversely associated with improvement in physical domain. Pleurodesis improved symptoms and quality of life in patients with malignant pleural effusion. Gender, lymphocyte count, and sclerosing agent might interfere with quality of life improvement.

Sections du résumé

BACKGROUND BACKGROUND
Malignant pleural effusion is one of the most important complications of metastatic cancer, and recurrent pleural effusions do not only have an impact on survival but also cause a huge repercussion on a patient's quality of life.
OBJECTIVES OBJECTIVE
The main objective was to describe quality of life status before and after pleurodesis in patients with malignant pleural effusion. Secondary, we aimed to find predictors of quality of life improvement in such a population.
METHODS METHODS
Retrospective analysis of a database collected prospectively. We included patients who underwent pleurodesis from June 2004 to July 2014. Quality of life was evaluated through the WHOQOL-BREF questionnaire and applied before and 30 days after pleurodesis. We used a paired t test and the Wilcoxon rank-sum to compare pre-/post-pleurodesis results, Kaplan-Meier curves for survival analysis, and multiple linear regressions to find predictors of quality of life improvement.
RESULTS RESULTS
183 patients were included (145 were women). Mean age was 58.3 ± 12.3 years, the most numerous primary tumor was breast cancer. Median survival time was 9 months. Dyspnea was the most prevalent symptom. Baseline results showed that patients had low quality of life scores. After pleurodesis, there was a significant improvement in respiratory symptoms, physical domain, and general health. Linear regression showed an improvement in physical domain with the sclerosing agent nitrate (p = 0.005). Male gender (p = 0.002) and a higher lymphocyte count (p = 0.01) were inversely associated with improvement in physical domain.
CONCLUSIONS CONCLUSIONS
Pleurodesis improved symptoms and quality of life in patients with malignant pleural effusion. Gender, lymphocyte count, and sclerosing agent might interfere with quality of life improvement.

Identifiants

pubmed: 31694026
pii: 000502029
doi: 10.1159/000502029
doi:

Substances chimiques

Nitrates 0
Talc 14807-96-6
Iodine 9679TC07X4

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

467-472

Informations de copyright

© 2019 S. Karger AG, Basel.

Auteurs

Ricardo Mingarini Terra (RM)

Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil, rmterra@uol.com.br.

Priscila Berenice Costa (PB)

Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.

Alberto Jorge Monteiro Dela Vega (AJM)

Instituto do Cancer do Estado de São Paulo, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.

Pedro Henrique Xavier Nabuco Araujo (PHXN)

Instituto do Cancer do Estado de São Paulo, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.

Lisete Ribeiro Teixeira (LR)

Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

Paulo Manuel Pêgo-Fernandes (PM)

Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

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Classifications MeSH