An examination of the factors for successful pleurodesis against malignant pleural effusion (MPE)

Background: OK-432 has been widely used in Japan for pleurodesis against MPE. Recently, TALC was able to use for pleurodesis against MPE under approval of Japanese medical insurance. Aim: To examine clinical factors for successful pleurodesis. Methods: We reviewed the medical record of patients who underwent pleurodesis against MPE from September 2010 to January 2016. A case without recurrent MPE during 30 days after the procedure was defined as a successful one. We also analyzed patient characteristics and adverse events. Results: Fifty nine trials of plurodesis for a total of 46 patients were performed during the period. The median age of patients was 70 (45 - 97) years old, male / female = 27 / 19, PS 0 / 1 / 2-3 / 4 = 2 / 39 / 17 / 1. Lung cancer, pleural mesothelioma, thymic cancer, and others were 37, 4, 1, and 4, respectively. Sixteen patients had TALC, 8 had OK-432, and 34 had OK-432 with minocycline. Two patients underwent pleurodesis for three times and 9 for twice, respectively. Five patients accomplished the procedure without removing the thoracic tube. The success rate was 31 % (5 / 16) in TALC group, 37.5 % (3 / 8) in OK-432 group, and 79 % (27 / 34) in OK-432 with minocycline group. Conclusion: In this study, OK-432 with minocycline group achieved high success rate of pleurodesis. We estimate that effective pleurodesis was provided when stronger inflammation happened to pleura by adding Minocycline to OK-432. As there is a deflection in the number of cases, we intend to perform a further research in the future. We are going to perform multivariate analysis to find clinical useful factors for successful pleurodesis against MPE.