MASSIVE PLEURAL EFFUSIONS IN CANCER PATIENTS: AN EXPERIENCE FROM A TERTIARY CARE CENTRE IN INDIA

Introduction Massive pleural effusions are typically characterised by collection of 1000 ml or more uid in the pleural cavity. It may be a malignant or a nonmalignant effusion and is common in cancer patients. Aims and objectives 1. To study the clinical prole of cancer patients who develop massive pleural effusions. 2. To analyse the management of massive pleural effusions in cancer patients. Materials and methods This is a retrospective study. Records of cancer patients diagnosed to have massive pleural effusions from the month of April 2022-November 2022, in our department were analysed in December 2022. Data regarding the clinical prole and management of pleural effusion of these patients was collected and analysed. Results During the study period,32 cancer patients were diagnosed to have a massive pleural effusion, out of which 24 had a malignant pleural effusion. The most common cause of malignant pleural effusion was lung cancer (38%), followed by breast cancer (29%). Therapeutic thoracocentesis alone was done for 14 patients. Therapeutic tapping was followed by Intercostal Chest Drain (ICD) insertion for 12 patients, whereas 6 patients had an upfront ICD inserted. Elderly age, ICD insertion and the development of hospital acquired pneumonia(HAP) were associated with signicantly longer duration of hospital stay. ICD insertion was signicantly associated with the development of HAP . No signicant difference was observed in the recurrence rate between patients who underwent ICD insertion vs therapeutic thoracocentesis alone. Conclusions Upfront ICD insertion for management of massive pleural effusions in cancer patients is associated with increased rates of HAP, prolonged duration of hospital stay and no difference in the rate of recurrence of effusions, when compared to patients who underwent therapeutic thoracocentesis alone. Thus, we suggest that these patients undergo therapeutic needle thoracocentesis as the rst line of management, with an attempt to avoid ICD insertion if possible.