Mortality after treatment of malignant pleural effusions with indwelling pleural catheters versus chemical pleurodesis: a population-based study.

Background: Little is known about patient outcomes following treatment of malignant pleural effusions (MPE) in the real-world setting.

Research Question: We aimed to compare post-procedure all-cause mortality between individuals who received indwelling pleural catheter (IPC) insertion versus chemical pleurodesis for managing MPEs.

Study Design And Methods: We performed a retrospective population-based study using provincial health administrative data (Ontario, Canada) of adults with a MPE who underwent IPC insertion or chemical pleurodesis between 2015 and 2019.

Resource Use and Costs of Indwelling Pleural Catheters versus Pleurodesis for Malignant Pleural Effusions: A Population-based Study.

Malignant pleural effusions (MPEs) are associated with significant health service use and healthcare costs, but the current evidence is limited. To compare 12-month post-procedure: ) health service utilization; and ) healthcare costs after indwelling pleural catheter (IPC) insertion with at-home drainage performed by home care nursing services, versus in-hospital chemical pleurodesis. We performed a retrospective population-based study on a cohort of adults with MPEs who underwent IPC insertion or chemical pleurodesis between January 1, 2015 and December 31, 2019 using provincial health administrative data (Ontario, Canada).

Patient perspectives on the use of indwelling pleural catheters in malignant pleural effusions.

Background: Indwelling pleural catheters are an effective treatment option for patients with malignant pleural effusions. Despite their popularity, there remains a paucity of data on the patient experience and key patient-centred outcomes.

Objective: To investigate the experience of patients receiving an indwelling pleural catheter to better inform and identify potential areas for improvement in care.

Use of a Novel, Shortened, Indwelling Pleural Catheter (PleurX) for the Ambulatory Management of Malignant Pleural Effusion: A Single Center Experience.

Background: Indwelling pleural catheters are frequently used for the treatment of malignant pleural effusion. The PleurX catheter (Becton, Dickinson and Company) is a commonly used indwelling pleural catheter across Canada. The traditional PleurX catheter is designed with a long segment of tubing outside of the patient's chest, making insertion, drainage, and dressing changes awkward.

Outcomes for Malignant Pleural Effusions Because of Melanoma Treated With Indwelling Pleural Catheters.

Background: Indwelling pleural catheters (IPCs) reduce dyspnea and improve quality of life in patients with malignant pleural effusions (MPEs). Data on outcomes of MPEs secondary to metastatic melanoma managed with IPCs are scarce. We aimed to evaluate outcomes of patients receiving IPCs for MPEs secondary to melanoma compared with other malignancies.

Diagnostic sensitivity of pleural fluid cytology in malignant pleural effusions: systematic review and meta-analysis.

Background: Pleural fluid cytology is an important diagnostic test used for the investigation of pleural effusions. There is considerable variability in the reported sensitivity for the diagnosis of malignant pleural effusions (MPE) in the literature.

Objective: The purpose of this review is to determine the diagnostic sensitivity of pleural fluid cytology for MPE, both overall and by tumour type, to better inform the decision-making process when investigating pleural effusions.

Effect of Needle Size on Diagnosis of Sarcoidosis with Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: Systematic Review and Meta-Analysis.

Sarcoidosis is a multisystem disease characterized by noncaseating granulomatous inflammation that most commonly involves the lungs. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become an invaluable tool in the assessment of patients with mediastinal and/or hilar lymphadenopathy. It has been hypothesized that use of the larger 19-gauge (G) needle with EBUS-TBNA improves diagnostic sensitivity in sarcoidosis.

Three Decades of Malignant Pleural Mesothelioma: An Academic Center Experience.

Background: Malignant pleural mesothelioma (MPM) remains a challenging disease to manage. In the past few decades, extrapleural pneumonectomy (EPP), pemetrexed-based chemotherapy, and indwelling pleural catheters were introduced to MPM care with variable levels of efficacy and evidence.

Patients And Methods: This was a retrospective review of patients diagnosed with MPM between January 1991 and March 2019.

Tract metastasis in patients with long-term pleural catheter-computed tomography diagnosis and longitudinal assessment.

Objectives: Long-term indwelling pleural catheters (IPC), used for the management of malignant pleural mesothelioma (MPM), may lead to catheter tract metastasis (CTM). While computed tomography (CT) is valuable for diagnosis, no studies have assessed CT manifestations of CTM. Our goal is to describe the incidence, CT appearances, and temporal evolution of CTM in MPM.

Early Readmission to Hospital in Patients With Cancer With Malignant Pleural Effusions: Analysis of the Nationwide Readmissions Database.

Background: Hospital readmissions are costly to health-care systems and represent a measure of quality care. Patients with cancer with malignant pleural effusions (MPEs) are at high risk for rehospitalization; however, risk factors for readmissions in this population are not well described. Understanding the incidence and risk factors for readmission could facilitate the development of a readmission reduction strategy in this patient population.

Clinical Predictors of Successful and Earlier Removal of Indwelling Pleural Catheters in Benign Pleural Effusions.

Background: Indwelling pleural catheters (IPCs) are an emerging therapy for persistent benign pleural effusions. IPCs may achieve pleurodesis and be removed.

Objectives: We aimed to identify factors associated with higher pleurodesis rates and earlier IPC removal in benign pleural effusions.

Catheter Tract Metastasis in Mesothelioma Patients with Indwelling Pleural Catheters: A Retrospective Cohort Study.

Background: Use of indwelling pleural catheters (IPCs) for the management of symptomatic pleural effusions in patients with mesothelioma has increased in popularity. An important concern with this approach is the potential for the development of catheter tract metastasis (CTM).

Objectives: To determine the incidence of IPC-related CTM in patients with malignant pleural mesothelioma (MPM).

Atezolizumab-induced sarcoid-like granulomatous reaction in a patient with urothelial cell carcinoma.

A 61-year-old woman with locally advanced, high-grade urothelial cell carcinoma was treated with the anti-programmed death-ligand 1 antibody atezolizumab. She initially received neoadjuvant chemotherapy and surgery that led to clinical and radiographic remission at the time of atezolizumab initiation. Within 3 months she developed new mediastinal and hilar lymphadenopathy as well as pulmonary nodules in a pattern characteristic of pulmonary sarcoidosis.

Effect of Chemotherapy on Removal of Indwelling Pleural Catheters in Breast Cancer Patients with Malignant Pleural Effusions.

Background: Indwelling pleural catheters (IPC) are commonly used in the management of malignant pleural effusions (MPE). The effect of systemic chemotherapy on IPC removal has not been reported previously.

Objectives: The purpose of this study is to identify the effect of chemotherapy on the removal of IPCs in breast cancer patients with MPEs.

Clinical predictors of successful and earlier pleurodesis with a tunnelled pleural catheter in malignant pleural effusion: a cohort study.

Background: Tunnelled pleural catheters used to treat malignant pleural effusions may achieve pleurodesis. We aimed to identify factors associated with higher pleurodesis rates and earlier catheter removal.

Methods: We retrospectively reviewed a prospective database of tunnelled pleural catheters inserted consecutively between May 2006 and June 2013 for confirmed malignant pleural effusion.

Participant selection for lung cancer screening by risk modelling (the Pan-Canadian Early Detection of Lung Cancer [PanCan] study): a single-arm, prospective study.

Background: Results from retrospective studies indicate that selecting individuals for low-dose CT lung cancer screening on the basis of a highly predictive risk model is superior to using criteria similar to those used in the National Lung Screening Trial (NLST; age, pack-year, and smoking quit-time). We designed the Pan-Canadian Early Detection of Lung Cancer (PanCan) study to assess the efficacy of a risk prediction model to select candidates for lung cancer screening, with the aim of determining whether this approach could better detect patients with early, potentially curable, lung cancer.

Methods: We did this single-arm, prospective study in eight centres across Canada.

Safety and Performance Characteristics of Outpatient Medical Thoracoscopy and Indwelling Pleural Catheter Insertion for Evaluation and Diagnosis of Pleural Disease at a Tertiary Center in Canada.

Background: Many centers performing medical thoracoscopy (MT) to diagnose pleural disease will insert a chest tube and admit patients to hospital after the procedure, which is inconvenient for patients and contributes to healthcare costs. We report the data on the safety, outcomes, and performance characteristics of outpatient MT with indwelling pleural catheter (IPC) insertion in a large Canadian cohort.

Methods: This retrospective cohort study reviewed patients who underwent outpatient MT and IPC insertion under conscious sedation.

An Algorithmic Approach for Assessment of Mediastinal Lesions Using Conventional Transbronchial Needle Aspiration and Endoscopic Ultrasonography in a Single Procedure.

Background: In the era of endobronchial/esophageal ultrasound (EBUS-TBNA/EUS-FNA), many centers forgo conventional transbronchial needle aspiration (C-TBNA) in favour of EBUS-TBNA/EUS-FNA despite no conclusive evidence showing better yields with EBUS-TBNA/EUS-FNA.

Objectives: Assess the feasibility of an algorithmic approach for mediastinal sampling beginning with C-TBNA utilizing rapid onsite cytologic evaluation.

Methods: Descriptive analysis of 92 consecutive patients referred for adenopathy that underwent C-TBNA and subsequent EBUS-TBNA/EUS-FNA if C-TBNA was negative or nondiagnostic.

The Cost-Effectiveness of High-Risk Lung Cancer Screening and Drivers of Program Efficiency.

Introduction: Lung cancer risk prediction models have the potential to make programs more affordable; however, the economic evidence is limited.

Methods: Participants in the National Lung Cancer Screening Trial (NLST) were retrospectively identified with the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. The high-risk subgroup was assessed for lung cancer incidence and demographic characteristics compared with those in the low-risk subgroup and the Pan-Canadian Early Detection of Lung Cancer Study (PanCan), which is an observational study that was high-risk-selected in Canada.

Management of Malignant Pleural Effusion with ASEPT® Pleural Catheter: Quality of Life, Feasibility, and Patient Satisfaction.

. The PleurX® IPC system has been used extensively in the past. Over time, management of MPE with the PleurX system can be costly.

The Palliative Management of Refractory Cirrhotic Ascites Using the PleurX (©) Catheter.

Background. Treatment options are limited for patients with refractory cirrhotic ascites (RCA). As such, we assessed the safety and effectiveness of the PleurX catheter for RCA.

Indwelling Peritoneal Catheters for Managing Malignancy-Associated Ascites.

We investigated use of the tunnelled catheter in a large palliative population with malignancy-associated ascites employing retrospective analysis of a prospectively maintained patient database of tunnelled peritoneal catheter insertions for refractory malignancy-associated ascites or new rapidly accumulating ascites. We found that a 100 percent procedural success rate was achieved with 395 tunnelled catheters inserted in 386 patients. Catheters remained in situ for 66 days, on average.