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Indwelling pleural catheter versus talc pleurodesis for malignant pleural effusion: a meta-analysis

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Abstract

Malignant pleural effusion (MPE) results from primary mesothelioma or the spreading of metastatic cancer. Both talc pleurodesis (TP) and indwelling pleural catheter (IPC) improve MPE symptoms. We performed a meta-analysis of randomized controlled trials to compare the efficacy of TP with that of IPC in patients with MPE. PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases were searched for studies published before February 2020. Individual effect sizes were standardized, and a meta-analysis was conducted to calculate a pooled effect size by using random effects models. In total, 4 trials with 500 patients were reviewed. Difference in pleurodesis success rate and change in dyspnea scores at 4 and 6 weeks between MPE patients treated with IPC and those treated with TP for pleurodesis were nonsignificant. The number of hospital inpatient days was significantly lower among patients who were treated with IPC (weight mean difference: 2.19; 95% confidence interval 0.70–3.67) than among those who were treated with TP. No significant difference was shown in adverse event profile between patients treated with IPC and those treated with TP for pleurodesis. In conclusion, both TP and IPC are equally effective in treating patients with MPE. The number of hospitalization days was significantly lower for patients who were treated with IPC, but the magnitude of the difference is of uncertain clinical importance.

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Abbreviations

CI:

Confidence interval

EQ-5D-5 L:

EuroQoL Group 5-Dimensions 5-Level Questionnaire

IPC:

Indwelling pleural catheter

MBS:

Modified Borg Scale

MeSH:

Medical subject headings

MPE:

Malignant pleural effusion

QLQ-C30:

quality of life questionnaire-core 30

QoL:

Quality of life

RCT:

Randomized controlled trials

RoB:

Risk of bias

RR:

Risk ratios

TP:

Talc pleurodesis

WMD:

Weighted mean difference

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Acknowledgements

We thank Mr. Eugene, Chun-Chit Cheng for assistance with data collection, and Wallace Academic Editing for edition of the manuscript.

Funding

This research received no specific Grant from any funding agency in the public, commercial, or not-for-profit sector.

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Authors and Affiliations

  1. Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong

    Maggie Yeung

  2. Centre for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan

    El-Wui Loh & Ka-Wai Tam

  3. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    El-Wui Loh

  4. Division of Thoracic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    Tung-Yu Tiong

  5. Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    Ka-Wai Tam

  6. Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Ka-Wai Tam

  7. Cochrane Taiwan, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Ka-Wai Tam

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  1. Maggie Yeung
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  2. El-Wui Loh
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Correspondence to Ka-Wai Tam.

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The authors Maggie Yeung, El-Wui Loh, Tung-Yu Tiong, and Ka-Wai Tam have no conflicts of interest or financial ties to disclose.

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Yeung, M., Loh, EW., Tiong, TY. et al. Indwelling pleural catheter versus talc pleurodesis for malignant pleural effusion: a meta-analysis. Clin Exp Metastasis 37, 541–549 (2020). https://doi.org/10.1007/s10585-020-10042-2

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  • DOI: https://doi.org/10.1007/s10585-020-10042-2

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