Talc Pleurodesis for Mesothelioma May Extend Survival

A UK study suggests that successful talc pleurodesis for mesothelioma improves survival better than other lung fluid treatments. 

Researchers in Oxford’s Chest Diseases Department analyzed the outcomes of two groups of pleural mesothelioma patients. Both groups underwent talc pleurodesis for mesothelioma. 

The patients whose lung fluid did not come back after treatment experienced longer survival. Mesothelioma patients who had to be retreated did not live as long. 

Pleural Effusion in Mesothelioma

The pleura is a membrane that surrounds and encases the lungs. It is supposed to be flexible and allow the lungs to move when a person breathes. 

But patients with pleural mesothelioma often develop pleural effusion. Pleural effusion is a build-up of excess fluid in the space between the layers of the pleura. As fluid builds up, it gets harder to breathe. 

Talc pleurodesis for mesothelioma is a method for treating pleural effusion. First, the surgeon drains the excess lung fluid. Then, the space is filled in with medicinal talc. The talc is supposed to trigger scarring in the pleura. The scars permanently fill the space.

Successful Versus Unsuccessful Talc Pleurodesis for Mesothelioma

When talc pleurodesis for mesothelioma is successful, lung fluid can no longer collect in the pleura. 

The Oxford team examined the outcomes of 329 patients who underwent talc pleurodesis. The cases they defined as “successful” did not need another treatment within three months. 

In one group, almost 50 percent of patients had successful talc pleurodesis for mesothelioma or another kind of cancer. In the second group, 79 percent of the treatments were successful. 

On average, these patients lived longer than those whose talc pleurodesis did not last. 

“Achieving pleurodesis seems to impart a survival benefit in patients with malignant pleural effusion,” writes study author Maged Hassan, MD, in the journal Lung Cancer. Dr, Hassan is also part of the medical faculty of Egypt’s Alexandria University. 

Pleurodesis Not the Only Option

Talc pleurodesis for mesothelioma may be the most advantageous way to deal with pleural effusion. But it is not the only way.

Some mesothelioma patients have indwelling pleural catheters to drain the fluid as it collects. Others have mechanical pleurodesis. Still others may undergo pleurocentesis to draw off the fluid.

The researchers say more studies are needed to understand how talc pleurodesis improves survival. They also want to know how survival compares to other methods for treating pleural effusion.

Source:

Hassan, M, et al, “Survival in patients with malignant pleural effusion undergoing talc pleurodesis”, September 4, 2019, Lung Cancer Epub ahead of print, https://www.lungcancerjournal.info/article/S0169-5002(19)30636-1/fulltext