Treatment of Malignant Pleural Effusions

This review addresses the treatment options for malignant pleural effusions by evaluating the multiple possible pathways to achieving fluid control. High pleurodesis rates can be achieved either by talc slurry with a chest drain, or talc poudrage via thoracoscopy. Outpatient management, using indwelling pleural catheters (IPCs), enables ambulatory home-based control of fluid, at the detriment of pleurodesis rates. Enhanced IPC techniques, such as combining with talc pleurodesis or using accelerated drainage strategies, can improve pleurodesis success rates. Early data suggest that combining IPC and thoracoscopic talc poudrage does not shorten length of hospitalization when compared to thoracoscopic talc poudrage alone.