open access

Vol 17, No 1 (2023)
Review paper
Published online: 2022-10-31
Get Citation


Juan David Botero1, Javier Iván Lasso2
DOI: 10.5603/PMPI.a2022.0028
Palliat Med Pract 2023;17(1):48-58.
  1. Clínica Cardiovid, Medellín, Colombia
  2. Hospital Universitario San Ignacio, Bogotá, Colombia

open access

Vol 17, No 1 (2023)
Review articles
Published online: 2022-10-31


Pleurodesis is a definitive management strategy in malignant pleural effusion, its history is briefly described, and a narrative review is made about its indication, patient selection, response predictors and benefits.


Pleurodesis is a definitive management strategy in malignant pleural effusion, its history is briefly described, and a narrative review is made about its indication, patient selection, response predictors and benefits.

Get Citation


pleurodesis, malignant pleural effusion, cancer, palliative care

About this article



Palliative Medicine in Practice


Vol 17, No 1 (2023)

Article type

Review paper



Published online


Page views


Article views/downloads




Bibliographic record

Palliat Med Pract 2023;17(1):48-58.


malignant pleural effusion
palliative care


Juan David Botero
Javier Iván Lasso

References (160)
  1. Charalampidis C, Youroukou A, Lazaridis G, et al. Physiology of the pleural space. J Thorac Dis. 2015; 7(Suppl 1): S33–S37.
  2. Zocchi L. Physiology and pathophysiology of pleural fluid turnover. Eur Respir J. 2002; 20(6): 1545–1558.
  3. Rodriguez-Panadero F, Antony VB. Pleurodesis: state of the art. Eur Respir J. 1997; 10(7): 1648–1654.
  4. Spengler L. Zur chirurgie des pneumothorax. Beitr Klin Chir. ; 1906(49): 80.
  5. Bethune N. Pleural poudrage. J Thorac Surg. 1935; 4(3): 251–261.
  6. Tyson M, Crandall W. The surgical treatment of recurrent idiopathic spontaneous pneumothorax. J Thorac Surg. 1941; 10(5): 566–571.
  7. Chambers JS. Palliative treatment of neoplastic pleural effusion with intercostal intubation and talc instillation. West J Surg Obstet Gynecol. 1958; 66(1): 26–28.
  8. Nandi P. Recurrent spontaneous pneumothorax; an effective method of talc poudrage. Chest. 1980; 77(4): 493–495.
  9. A survey of the long-term effects of talc and kaolin pleurodesis. Research Committee of the British Thoracic Association and the Medical Research Council Pneumoconiosis Unit. Br J Dis Chest. 1979; 73(3): 285–288.
  10. Adler RH, Levinsky L. Persistent chylothorax. Treatment by talc pleurodesis. J Thorac Cardiovasc Surg. 1978; 76(6): 859–864.
  11. Viskum K, Lange P, Mortensen J. Long term sequelae after talc pleurodesis for spontaneous pneumothorax. Pneumologie. 1989; 43(2): 105–106.
  12. Andersen I, Nissen H. Results of silver nitrate pleurodesis in spontaneous pneumothorax. Dis Chest. 1968; 54(3): 230–233.
  13. Echavarría A, Pinzón V, Barés JP, et al. [Intracavitary treatment of malignant pleural effusion with iodine-povidone]. Rev Med Panama. 1991; 16(1): 69–74.
  14. Wied U, Halkier E, Hoeier-Madsen K, et al. Tetracycline versus silver nitrate pleurodesis in spontaneous pneumothorax. J Thorac Cardiovasc Surg. 1983; 86(4): 591–593.
  15. Dikensoy O, Zhu Z, Donnelly E, et al. Combination therapy with intrapleural doxycycline and talc in reduced doses is effective in producing pleurodesis in rabbits. Chest. 2005; 128(5): 3735–3742.
  16. Salomaa ER, Pulkki K, Helenius H. Pleurodesis with doxycycline or Corynebacterium parvum in malignant pleural effusion. Acta Oncol. 1995; 34(1): 117–121.
  17. Prevost A, Nazeyrollas P, Milosevic D, et al. Malignant pleural effusions treated with high dose intrapleural doxycycline: clinical efficacy and tolerance. Oncol Rep. 1998; 5(2): 363–366.
  18. Walker-Renard PB, Vaughan LM, Sahn SA. Chemical pleurodesis for malignant pleural effusions. Ann Intern Med. 1994; 120(1): 56–64.
  19. Patz EF, McAdams HP, Erasmus JJ, et al. Sclerotherapy for malignant pleural effusions: a prospective randomized trial of bleomycin vs doxycycline with small-bore catheter drainage. Chest. 1998; 113(5): 1305–1311.
  20. Dikensoy O, Light RW. Alternative widely available, inexpensive agents for pleurodesis. Curr Opin Pulm Med. 2005; 11(4): 340–344.
  21. Hsu LH, Feng AC, Soong TC, et al. Clinical outcomes of chemical pleurodesis using a minocycline. Ther Adv Respir Dis. 2019; 13: 1753466619841231.
  22. Daddi N, Vannucci J, Maggio C, et al. Efficacy of tigecycline pleurodesis: a comparative experimental study. J Surg Res. 2011; 169(2): e109–e118.
  23. Yilmaz N, Zeybek A, Tharian B, et al. Efficacy of nonsurgical tigecycline pleurodesis for the management of hepatic hydrothorax in patients with liver cirrhosis. Surg Case Rep. 2015; 1(1): 62.
  24. Stiksa G, Korsgaard R, Simonsson BG. Treatment of recurrent pleural effusion by pleurodesis with quinacrine. Comparison between instillation by repeated thoracenteses and by tube drainage. Scand J Respir Dis. 1979; 60(4): 197–205.
  25. Boe J, Florvaag E. [Chemical pleurodesis induced by mepacrine chloride. An alternative in the treatment of malignant pleural effusions]. Tidsskr Nor Laegeforen. 1976; 96(23): 1203–1206.
  26. Luh KT, Yang PC, Kuo SH, et al. Comparison of OK-432 and mitomycin C pleurodesis for malignant pleural effusion caused by lung cancer. A randomized trial. Cancer. 1992; 69(3): 674–679, doi: 10.1002/1097-0142(19920201)69:3<674::aid-cncr2820690313>;2-5.
  27. Cheng D, Chan YM, Ng TY, et al. Mitomycin chemotherapeutic pleurodesis to palliate malignant pleural effusions secondary to gynecological cancer. Acta Obstet Gynecol Scand. 1999; 78(5): 443–446.
  28. Sreter KB, Jakopovic M, Janevski Z, et al. A pilot study-is there a role for mitoxantrone pleurodesis in the management of pleural effusion due to lung cancer? Ann Transl Med. 2016; 4(9): 162.
  29. van Belle AF, ten Velde GP, Wouters EF. Chemical pleurodesis with mitoxantrone in the management of malignant effusions. Eur J Cancer. 1998; 34(1): 205–206.
  30. Wang CQ, Huang XR, He M, et al. Intrapleural administration with rh-endostatin and chemical irritants in the control of malignant pleural effusion: a systematic review and meta-analysis. Front Oncol. 2021; 11: 649999.
  31. Sasaki T, Yasuda H, Nakayama K, et al. Pleurodesis with carboplatin in elderly patients with malignant pleural effusion and lung adenocarcinoma. J Am Geriatr Soc. 2006; 54(4): 722–723.
  32. Foresti V. Intrapleural Corynebacterium parvum for recurrent malignant pleural effusions. Respiration. 1995; 62(1): 21–26.
  33. Ishihara K, Hasegawa T, Okazaki M, et al. [OK432 chemical pleurodesis as a standard therapy of spontaneous pneumothorax]. Nihon Kyobu Shikkan Gakkai Zasshi. 1988; 26(1): 10–15.
  34. Jiang H, Yang XM, Wang CQ, et al. Intrapleural perfusion with staphylococcal enterotoxin c for malignant pleural effusion: a clustered systematic review and meta-analysis. Front Med (Lausanne). 2022; 9: 816973.
  35. Ren S, Terman DS, Bohach G, et al. Intrapleural staphylococcal superantigen induces resolution of malignant pleural effusions and a survival benefit in non-small cell lung cancer. Chest. 2004; 126(5): 1529–1539.
  36. Rahman NM, Davies HE, Salzberg M, et al. Use of lipoteichoic acid-T for pleurodesis in malignant pleural effusion: a phase I toxicity and dose-escalation study. Lancet Oncol. 2008; 9(10): 946–952.
  37. Keeratichananont W, Kaewdech A, Keeratichananont S. Efficacy and safety profile of autologous blood versus talc pleurodesis for malignant pleural effusion: a randomized controlled trial. Ther Adv Respir Dis. 2018; 12: 1753466618816625.
  38. Martínez-Escobar S, Ruiz-Bailén M, Lorente-Acosta MJ, et al. Pleurodesis using autologous blood: a new concept in the management of persistent air leak in acute respiratory distress syndrome. J Crit Care. 2006; 21(2): 209–216.
  39. Narenchandra V, Vishnukanth G, Dwivedi DP, et al. Comparison of efficacy of autologous blood patch pleurodesis versus doxycycline pleurodesis in the management of persistent air leak in patients with secondary spontaneous pneumothorax. A randomized control trial. Monaldi Arch Chest Dis. 2022 [Epub ahead of print].
  40. Hamada S, Okamoto N, Watanabe I, et al. Is pleurodesis with 50% glucose solution in patients with spontaneous pneumothorax safe?: A case series. Arch Bronconeumol. 2017; 53(4): 210–211.
  41. Chen Y, Li C, Xu L, et al. Novel treatment for chylothorax after esophagectomy with 50% glucose pleurodesis. Ann Vasc Surg. 2010; 24(5): 694.e9–694.13.
  42. Tsukioka T, Inoue K, Oka H, et al. Intraoperative mechanical and chemical pleurodesis with 50 % glucose solution for secondary spontaneous pneumothorax in patients with pulmonary emphysema. Surg Today. 2013; 43(8): 889–893.
  43. Song KS, Keum D, Kim JB. Chemical pleurodesis using doxycycline and extract. Korean J Thorac Cardiovasc Surg. 2017; 50(4): 281–286.
  44. Kim JD, Choi JW, Park HOh, et al. Chemical pleurodesis with L. extract for secondary spontaneous pneumothorax in elderly patients. J Thorac Dis. 2020; 12(10): 5440–5445.
  45. Park JB, Lee SAm, Lee WS, et al. The management of chemical pleurodesis with viscum album in patients with persistent air leakage. J Thorac Dis. 2018; 10(1): 371–376.
  46. Mai Z, Feng B, He Q, et al. Medical Thoracoscopic Thermal Ablation Therapy for Metastatic Pleural Tumors with Malignant Effusion: An Exploratory Retrospective Study. Int J Gen Med. 2021; 14: 9349–9360.
  47. Yazicioglu A, Uysal S, Sahinoglu T, et al. Does sericin, as a novel pleurodesis agent, have higher effectiveness compared to talcum powder, doxycycline, and silver nitrate pleurodesis? Arch Bronconeumol (Engl Ed). 2019; 55(7): 357–367.
  48. Lee YCG, Teixeira LR, Devin CJ, et al. Transforming growth factor-beta2 induces pleurodesis significantly faster than talc. Am J Respir Crit Care Med. 2001; 163(3): 640–644.
  49. Bhatnagar R, Keenan EK, Morley AJ, et al. Outpatient talc administration by indwelling pleural catheter for malignant effusion. N Engl J Med. 2018; 378(14): 1313–1322.
  50. Kaul V, McCracken DJ, Rahman NM, et al. Contemporary approach to the diagnosis of malignant pleural effusion. Ann Am Thorac Soc. 2019; 16(9): 1099–1106.
  51. Ferrer J, Roldán J, Teixidor J, et al. Predictors of pleural malignancy in patients with pleural effusion undergoing thoracoscopy. Chest. 2005; 127(3): 1017–1022.
  52. Karpathiou G, Mobarki M, Stachowicz ML, et al. Pericardial and pleural metastases: clinical, histologic, and molecular differences. Ann Thorac Surg. 2018; 106(3): 872–879.
  53. Sahn SA. Pleural diseases related to metastatic malignancies. Eur Respir J. 1997; 10(8): 1907–1913.
  54. Chernow B, Sahn S. Carcinomatous involvement of the pleura. The American Journal of Medicine. 1977; 63(5): 695–702.
  55. Clive AO, Kahan BC, Hooper CE, et al. Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score. Thorax. 2014; 69(12): 1098–1104.
  56. Jovanovic D. Etiopathogenesis of malignant pleural effusion. AME Medical Journal. 2021; 6: 28–28.
  57. Awadallah SF, Bowling MR, Sharma N, et al. Malignant pleural effusion and cancer of unknown primary site: a review of literature. Ann Transl Med. 2019; 7(15): 353.
  58. Awasthi A, Gupta N, Srinivasan R, et al. Cytopathological spectrum of unusual malignant pleural effusions at a tertiary care centre in north India. Cytopathology. 2007; 18(1): 28–32.
  59. Puchalski JT, Argento AC, Murphy TE, et al. Etiologies of bilateral pleural effusions. Respir Med. 2013; 107(2): 284–291.
  60. Tian P, Qiu R, Wang M, et al. Prevalence, causes, and health care burden of pleural effusions among hospitalized adults in china. JAMA Netw Open. 2021; 4(8): e2120306.
  61. Kellie S, Pfister G, Mann J, et al. A novel approach to classifying pleural effusions using a new reagent. Chest. 2012; 142(4).
  62. Chae G, Jun JB, Jung HS, et al. Histiocytic pleural effusion: the strong clue to malignancy. World J Surg Oncol. 2021; 19(1): 180.
  63. Lee J, Lee YH, Seo H, et al. Laboratory discrimination between neutrophilic malignant and parapneumonic pleural effusions. Am J Med Sci. 2019; 358(2): 115–120.
  64. Popowicz N, Cheah HM, Gregory C, et al. Neutrophil-to-lymphocyte ratio in malignant pleural fluid: Prognostic significance. PLoS One. 2021; 16(4): e0250628.
  65. Johnson L, Fakih HA, Daouk S, et al. Transudative pleural effusion of malignant etiology: Rare but real. Respir Med Case Rep. 2017; 20: 188–191.
  66. Ryu JS, Ryu ST, Kim YS, et al. What is the clinical significance of transudative malignant pleural effusion? Korean J Intern Med. 2003; 18(4): 230–233.
  67. Yang J, Lee OJ, Son SM, et al. EGFR mutation status in lung adenocarcinoma-associated malignant pleural effusion and efficacy of EGFR tyrosine kinase inhibitors. Cancer Res Treat. 2018; 50(3): 908–916.
  68. Stathopoulos GT. Translational advances in pleural malignancies. Respirology. 2011; 16(1): 53–63.
  69. Holling N, Patole S, Medford ARL, et al. Is systemic anticancer therapy associated with higher rates of malignant pleural effusion control in people with pharmacologically sensitive tumors?: A retrospective analysis of prospectively collected data. Chest. 2021; 160(5): 1915–1924.
  70. Verma A, Chopra A, Lee YW, et al. Can EGFR-tyrosine kinase inhibitors (TKI) alone without talc pleurodesis prevent recurrence of malignant pleural effusion (MPE) in lung adenocarcinoma. Curr Drug Discov Technol. 2016; 13(2): 68–76.
  71. Kashiwabara K, Fuji S, Tsumura S, et al. Prognosis of -mutant lung adenocarcinoma patients with malignant pleural effusion receiving first-line EGFR-TKI therapy without pleurodesis: a single-institute retrospective study. Anticancer Res. 2020; 40(2): 1117–1121.
  72. Yin W, Zhang H, Gu Y, et al. [Clinical characteristics and prognosis of 76 lung adenocarcinoma patients harboring EGFR mutations with pleural effusion at initial diagnosis: a single-center retrospective study]. Zhongguo Fei Ai Za Zhi. 2022; 25(3): 156–166.
  73. Anevlavis S, Kouliatsis G, Sotiriou I, et al. Prognostic factors in patients presenting with pleural effusion revealing malignancy. Respiration. 2014; 87(4): 311–316.
  74. Chiang KY, Ho JCM, Chong P, et al. Role of early definitive management for newly diagnosed malignant pleural effusion related to lung cancer. Respirology. 2020; 25(11): 1167–1173.
  75. Psallidas I, Kanellakis NI, Gerry S, et al. Development and validation of response markers to predict survival and pleurodesis success in patients with malignant pleural effusion (PROMISE): a multicohort analysis. Lancet Oncol. 2018; 19(7): 930–939.
  76. Feller-Kopman DJ, Reddy CB, DeCamp MM, et al. Management of malignant pleural effusions. An official ATS/STS/STR clinical practice guideline. Am J Respir Crit Care Med. 2018; 198(7): 839–849.
  77. N Maskell, N Rahman, M Roberts, A Bibby, K Blyth, J Corcoran, et al. BTS Guideline for Pleural Disease. 2022.
  78. Heinke MY, Vinod SK. A review on the impact of lung cancer multidisciplinary care on patient outcomes. Transl Lung Cancer Res. 2020; 9(4): 1639–1653.
  79. Croke JM, El-Sayed S. Multidisciplinary management of cancer patients: chasing a shadow or real value? An overview of the literature. Curr Oncol. 2012; 19(4): e232–e238.
  80. Pillay B, Wootten AC, Crowe H, et al. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: A systematic review of the literature. Cancer Treat Rev. 2016; 42: 56–72.
  81. Mierzejewski M, Korczynski P, Krenke R, et al. Chemical pleurodesis - a review of mechanisms involved in pleural space obliteration. Respir Res. 2019; 20(1): 247.
  82. Rodriguez-Panadero F, Montes-Worboys A. Mechanisms of Pleurodesis. Respiration. 2012; 83(2): 91–98.
  83. Hobbs SB, Martin JT, Walker CM, et al. Nodular pleural thickening after lobectomy for lung cancer. Insights on imaging of the pleura. Ann Am Thorac Soc. 2016; 13(8): 1424–1425.
  84. Bhupathy S, Huynh T. Positive 18f-fluorodeoxyglucose positron emission tomography/computed tomography 20 years after talc pleurodesis. World J Nucl Med. 2022.
  85. Parshall MB, Schwartzstein RM, Adams L, et al. American Thoracic Society Committee on Dyspnea. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012; 185(4): 435–452.
  86. Agustí AG, Cardús J, Roca J, et al. Ventilation-perfusion mismatch in patients with pleural effusion: effects of thoracentesis. Am J Respir Crit Care Med. 1997; 156(4 Pt 1): 1205–1209.
  87. Richard W. Light. Pleural Diseases. 6th edition. Lippincott Williams & Wilkins. ; 2013.
  88. Cartaxo AM, Vargas FS, Salge JM, et al. Improvements in the 6-min walk test and spirometry following thoracentesis for symptomatic pleural effusions. Chest. 2011; 139(6): 1424–1429.
  89. Thomas R, Jenkins S, Eastwood PR, et al. Physiology of breathlessness associated with pleural effusions. Curr Opin Pulm Med. 2015; 21(4): 338–345.
  90. DeBiasi EM, Feller-Kopman D. Physiologic basis of symptoms in pleural disease. Semin Respir Crit Care Med. 2019; 40(3): 305–313.
  91. Marcondes BF, Vargas F, Paschoal FH, et al. Sleep in patients with large pleural effusion: impact of thoracentesis. Sleep Breath. 2012; 16(2): 483–489.
  92. MacDuff A, Arnold A, Harvey J, et al. BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010; 65 Suppl 2: ii18–ii31.
  93. Andres JJR, Canto A, Moya J. Pleurodesis: indicaciones, tecnicas y resultados. Archivos de Bronconeumología. 1984; 20(6): 256–263.
  94. Sonoda A, Jeudy J, White CS, et al. Pleurodesis: indications and radiologic appearance. Jpn J Radiol. 2015; 33(5): 241–245.
  95. Rafei H, Jabak S, Mina A, Tfayli A. Pleurodesis in malignant pleural effusions: Outcome and predictors of success. Integr Cancer Sci Ther [Internet]. 2015. (10.09.2022).
  96. Bhatnagar R, Luengo-Fernandez R, Kahan BC, et al. Thoracoscopy and talc poudrage compared with intercostal drainage and talc slurry infusion to manage malignant pleural effusion: the TAPPS RCT. Health Technol Assess. 2020; 24(26): 1–90.
  97. Bhatnagar R, Piotrowska HEG, Laskawiec-Szkonter M, et al. Effect of thoracoscopic talc poudrage vs talc slurry via chest tube on pleurodesis failure rate among patients with malignant pleural effusions: a randomized clinical trial. JAMA. 2020; 323(1): 60–69.
  98. Lee YC, Baumann MH, Maskell NA, et al. Pleurodesis practice for malignant pleural effusions in five English-speaking countries: survey of pulmonologists. Chest. 2003; 124(6): 2229–2238.
  99. Diacon AH, Wyser C, Bolliger CT, et al. Prospective randomized comparison of thoracoscopic talc poudrage under local anesthesia versus bleomycin instillation for pleurodesis in malignant pleural effusions. Am J Respir Crit Care Med. 2000; 162(4 Pt 1): 1445–1449.
  100. Sherman S, Ravikrishnan KP, Patel AS, et al. Optimum anesthesia with intrapleural lidocaine during chemical pleurodesis with tetracycline. Chest. 1988; 93(3): 533–536.
  101. Wooten SA, Barbarash RA, Strange C, et al. Systemic absorption of tetracycline and lidocaine following intrapleural instillation. Chest. 1988; 94(5): 960–963.
  102. Thethi I, Ramirez S, Shen W, et al. Effect of chest tube size on pleurodesis efficacy in malignant pleural effusion: a meta-analysis of randomized controlled trials. J Thorac Dis. 2018; 10(1): 355–362.
  103. Xie C, Teixeira LR, McGovern JP, et al. Systemic corticosteroids decrease the effectiveness of talc pleurodesis. Am J Respir Crit Care Med. 1998; 157(5 Pt 1): 1441–1444.
  104. Rahman NM, Pepperell J, Rehal S, et al. Effect of opioids vs nsaids and larger vs smaller chest tube size on pain control and pleurodesis efficacy among patients with malignant pleural effusion: the TIME1 randomized clinical trial. JAMA. 2015; 314(24): 2641–2653.
  105. Stefani A, Natali P, Casali C, et al. Talc poudrage versus talc slurry in the treatment of malignant pleural effusion. A prospective comparative study. Eur J Cardiothorac Surg. 2006; 30(6): 827–832.
  106. Mager HJ, Maesen B, Verzijlbergen F, et al. Distribution of talc suspension during treatment of malignant pleural effusion with talc pleurodesis. Lung Cancer. 2002; 36(1): 77–81.
  107. Dryzer SR, Allen ML, Strange C, et al. A comparison of rotation and nonrotation in tetracycline pleurodesis. Chest. 1993; 104(6): 1763–1766.
  108. Lamb C, Li A, Thakkar D, et al. Pleurodesis. Semin Respir Crit Care Med. 2019; 40(3): 375–385.
  109. Villanueva AG, Gray AW, Shahian DM, et al. Efficacy of short term versus long term tube thoracostomy drainage before tetracycline pleurodesis in the treatment of malignant pleural effusions. Thorax. 1994; 49(1): 23–25.
  110. Psallidas I, Hassan M, Yousuf A, et al. Role of thoracic ultrasonography in pleurodesis pathways for malignant pleural effusions (SIMPLE): an open-label, randomised controlled trial. Lancet Respir Med. 2022; 10(2): 139–148.
  111. Ford A, Jennings S, Tharion J. Low serum albumin as a predictor of poor outcome in pleurodesis for malignant pleural effusion. Heart, Lung and Circulation. 2015; 24: e9.
  112. Li P, Graver A, Hosseini S, et al. Clinical predictors of successful and earlier pleurodesis with a tunnelled pleural catheter in malignant pleural effusion: a cohort study. CMAJ Open. 2018; 6(2): E235–E240.
  113. Barbetakis N, Asteriou C, Papadopoulou F, et al. Early and late morbidity and mortality and life expectancy following thoracoscopic talc insufflation for control of malignant pleural effusions: a review of 400 cases. J Cardiothorac Surg. 2010; 5: 27.
  114. Hassan M, Gadallah M, Mercer RM, et al. Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis. Expert Rev Respir Med. 2020; 14(6): 645–654.
  115. Zablockis R, Danila E, Gruslys V, et al. Systemic inflammatory response to different sclerosing agents as a predictor of pleurodesis outcome. In Vivo. 2021; 35(4): 2391–2398.
  116. Thomas R, Francis R, Davies HE, et al. Interventional therapies for malignant pleural effusions: the present and the future. Respirology. 2014; 19(6): 809–822.
  117. Dipper A, Jones HE, Bhatnagar R, et al. Interventions for the management of malignant pleural effusions: a network meta-analysis. Cochrane Database Syst Rev. 2020; 4(160): CD010529.
  118. Paschoalini Md, Vargas FS, Marchi E, et al. Prospective randomized trial of silver nitrate vs talc slurry in pleurodesis for symptomatic malignant pleural effusions. Chest. 2005; 128(2): 684–689.
  119. Menna C, Andreetti C, Ibrahim M, et al. The effect of silver nitrate pleurodesis after a failed thoracoscopic talc poudrage. Biomed Res Int. 2013; 2013: 295890.
  120. Bilaçeroğlu S, Cağirici U, Perim K, et al. Corynebacterium parvum pleurodesis and survival is not significantly influenced by pleural pH and glucose level. Monaldi Arch Chest Dis Arch Monaldi Mal Torace. 1998; 53: 14–22.
  121. Shehata S, Sileem A, El-Fakharany K. Pleural fluid CRP, LDH, and pH as predictors of successful pleurodesis in malignant pleural effusions. Egypt J Chest Dis Tuber. 2015; 64(3): 593–599.
  122. Hassaan K. Combination therapy with intrapleural doxycycline and talc in reduced doses for pleurodesi. Eur Respir J. 2012; 40 (Suppl 56)(P1265).
  123. Emad A, Rezaian GR. Treatment of malignant pleural effusions with a combination of bleomycin and tetracycline. A comparison of bleomycin or tetracycline alone versus a combination of bleomycin and tetracycline. Cancer. 1996; 78(12): 2498–2501, doi: 10.1002/(sici)1097-0142(19961215)78:12<2498::aid-cncr8>;2-g.
  124. Kumar S, Sonkar A, Kumar D, et al. Comparative evaluation of VATS assisted combined mechanical and chemical pleurodesis with chemical pleurodesis—is it worthwhile? Indian J Thorac Cardiovasc Surg. 2013; 29(2): 106–109.
  125. Mohsen TA, Zeid AA, Meshref M, et al. Local iodine pleurodesis versus thoracoscopic talc insufflation in recurrent malignant pleural effusion: a prospective randomized control trial. Eur J Cardiothorac Surg. 2011; 40(2): 282–286.
  126. Bellini A, Tarrazzi F, Tami C, et al. Intrapleural fibrinolytic therapy improves results with talc slurry pleurodesis. Cureus. 2020; 12(8): e10122.
  127. Wahidi MM, Reddy C, Yarmus L, et al. Randomized trial of pleural fluid drainage frequency in patients with malignant pleural effusions. The ASAP trial. Am J Respir Crit Care Med. 2017; 195(8): 1050–1057.
  128. Shrager JB, Bhatnagar R, Kearney CT, et al. Silver nitrate-coated versus standard indwelling pleural catheter for malignant effusions: the SWIFT randomized trial. Ann Am Thorac Soc. 2022; 19(10): 1722–1729.
  129. Santos PS, Marques MA, Cruz C, et al. Predictors of talc slurry pleurodesis success in patients with malignant pleural effusions. Rev Port Pneumol (2006). 2017; 23(4): 216–220.
  130. Yoon DW, Cho JHo, Choi YS, et al. Predictors of survival in patients who underwent video-assisted thoracic surgery talc pleurodesis for malignant pleural effusion. Thorac Cancer. 2016; 7(4): 393–398.
  131. D'Ambrosio PD, de Araújo PH, Junior ER, et al. Risk factors related to pleural empyema after talc slurry pleurodesis. Clinics (Sao Paulo). 2022; 77: 100098.
  132. Terra RM, da Costa PB, Dela Vega AJ, et al. Adverse events after pleurodesis in patients with malignant pleural effusion. J Thorac Dis. 2020; 12(7): 3507–3513.
  133. Bridevaux PO, Tschopp JM, Cardillo G, et al. Short-term safety of thoracoscopic talc pleurodesis for recurrent primary spontaneous pneumothorax: a prospective European multicentre study. Eur Respir J. 2011; 38(4): 770–773.
  134. Montes JF, Ferrer J, Villarino MA, et al. Influence of talc dose on extrapleural talc dissemination after talc pleurodesis. Am J Respir Crit Care Med. 2003; 168(3): 348–355.
  135. Griffo S, Musumeci A, De Luca G, et al. Talc-induced interstitial pneumonitis with respiratory failure. Anaesth Intensive Care. 2009; 37(1): 127–129.
  136. Rehse DH, Aye RW, Florence MG. Respiratory failure following talc pleurodesis. Am J Surg. 1999; 177(5): 437–440.
  137. Evans TJ, Sivakumar P, Ahmed L. Progressive respiratory failure: a rare complication after graded talc pleurodesis. Br J Hosp Med (Lond). 2017; 78(5): 294–295.
  138. Park S, Lee H, Kim D, et al. Two cases of fatal hypoxemia after talc pleurodesis for recurrent malignant pleural effusion. Tuberc Respir Dis. 2007; 62(3): 217.
  139. Noh D, Park JS, Lee DY. Acute respiratory distress syndrome after pleurodesis for primary spontaneous pneumothorax. Korean J Thorac Cardiovasc Surg. 2017; 50(1): 64–67.
  140. Amundson WH, Racila E, Allen T, et al. Acute exacerbation of interstitial lung disease after procedures. Respir Med. 2019; 150: 30–37.
  141. Shinno Y, Kage H, Chino H, et al. Old age and underlying interstitial abnormalities are risk factors for development of ARDS after pleurodesis using limited amount of large particle size talc. Respirology. 2018; 23(1): 55–59.
  142. Zhang W, Zhao YL, Li SJ, et al. Complications of thoracoscopic talc insufflation for the treatment of malignant pleural effusions: a meta-analysis. J Cardiothorac Surg. 2021; 16(1): 125.
  143. Milton R, Cale ARJ. Chronic pain due to talc pleurodesis for spontaneous pneumothorax. Ann Thorac Surg. 2003; 76(5): 1740–1741.
  144. Cardillo G, Carleo F, Giunti R, et al. Videothoracoscopic talc poudrage in primary spontaneous pneumothorax: a single-institution experience in 861 cases. J Thorac Cardiovasc Surg. 2006; 131(2): 322–328.
  145. Noppen M. Who's (still) afraid of talc? Eur Respir J. 2007; 29(4): 619–621.
  146. Yokoe N, Katsuda E, Kosaka K, et al. Interstitial lung disease after pleurodesis for malignant pleural effusion. Intern Med. 2017; 56(14): 1791–1797.
  147. Togo T, Ota S, Hirose M, et al. [Air embolism at the pleurodesis for air leakage after pulmonary resection]. Kyobu Geka. 2012; 65(3): 201–204.
  148. Wagenfeld L, Zeitz O, Richard G. Visual loss after povidone-iodine pleurodesis. N Engl J Med. 2007; 357(12): 1264–1265.
  149. Agarwal R, Khan A, Aggarwal AN, et al. Efficacy & safety of iodopovidone pleurodesis: a systematic review & meta-analysis. Indian J Med Res. 2012; 135: 297–304.
  150. Chaugle H, Parchment C, Keenan DJ, et al. Overdose of tetracycline for pleurodesis leading to chemical burns of the pleura. Eur J Cardiothorac Surg. 1999; 16(4): 469–470.
  151. Smythe WR, Bavaria JE. Tetracycline pleurodesis--associated acute renal failure. Chest. 1993; 104(4): 1274–1276.
  152. Li CY, Kuo SW, Lee JM. Life-threatening complications related to minocycline pleurodesis. Ann Thorac Surg. 2011; 92(3): 1122–1124.
  153. Puri V, Pyrdeck TL, Crabtree TD, et al. Treatment of malignant pleural effusion: a cost-effectiveness analysis. Ann Thorac Surg. 2012; 94(2): 374–9; discussion 379.
  154. Olfert JAP, Penz ED, Manns BJ, et al. Cost-effectiveness of indwelling pleural catheter compared with talc in malignant pleural effusion. Respirology. 2017; 22(4): 764–770.
  155. Mishra EK, Corcoran JP, Hallifax RJ, et al. Defining the minimal important difference for the visual analogue scale assessing dyspnea in patients with malignant pleural effusions. PLoS One. 2015; 10(4): e0123798.
  156. Ries AL. Minimally clinically important difference for the UCSD Shortness of Breath Questionnaire, Borg Scale, and Visual Analog Scale. COPD. 2005; 2(1): 105–110.
  157. Davies HE, Mishra EK, Kahan BC, et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial. JAMA. 2012; 307(22): 2383–2389.
  158. Hassan M, Harriss E, Mercer RM. Survival and pleurodesis outcome in patients with malignant pleural effusion – a systematic review. Pleura and Peritoneum. 2021; 6(1): 1–5.
  159. Hassan M, Mercer RM, Maskell NA, et al. Survival in patients with malignant pleural effusion undergoing talc pleurodesis. Lung Cancer. 2019; 137: 14–18.
  160. Wajda A, Engström H, Persson HL. Medical talc pleurodesis: which patient with cancer benefits least? J Palliat Med. 2014; 17(7): 822–828.


Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73 , 80–180 Gdańsk, Poland

phone:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: