ArticleEuropean journal of medical research2026
Talc pleurodesis versus indwelling pleural catheter for refractory pleural effusion: a prospective study of survival and complications.
Article in European journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Determinants of Chemical Pleurodesis Recurrence in Malignant Pleural Effusion: Mechanical Apposition or Systemic Inflammation? A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2026Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of refractory pleural effusion presents a significant clinical challenge. This study aims to compare the outcomes of thoracoscopic talc pleurodesis (TP) and indwelling pleural catheter (IPC) insertion, focusing on survival, complications, and healthcare utilization, while accounting for baseline performance status.
methodsWe conducted a prospective cohort study in 2024 at a single tertiary care center, enrolling 101 patients with refractory pleural effusion. Patients were allocated to either the IPC group (n = 72, 71.3%) or the TP group (n = 29, 28.7%). Primary outcomes included overall survival, length of hospital stay, and total treatment duration. Secondary outcomes were pleurodesis success rate, effusion recurrence, and procedure-related complications. Multivariate analysis was performed to adjust for confounders including age, ECOG performance status, and etiology.
resultsThe IPC group had a significantly shorter median hospital stay (1 day vs. 7 days; p < 0.001). Unadjusted survival was significantly lower in the IPC group compared to the TP group at 12 months (13.3% vs. 62.1%; p < 0.001). However, after adjusting for ECOG performance status and age in a multivariate Cox regression, the treatment modality was no longer an independent predictor of mortality (HR 0.78, 95% CI 0.41-1.48; p = 0.45), whereas ECOG score remained a strong predictor (HR 1.65, 95% CI 1.32-2.06; p < 0.001). TP achieved a 100% pleurodesis success rate, compared to 25.4% for IPC (p < 0.001). IPC patients reported less chest pain (13.9% vs. 48.3%; p < 0.001) and bleeding (1.4% vs. 20.7%; p = 0.002).
conclusionA significant trade-off exists between the two procedures. IPC is associated with shorter hospitalization and fewer acute complications, while TP offers definitive effusion control. The observed survival difference in the TP group appears to be driven by the selection of fitter patients with better performance status for the more invasive procedure, rather than a direct therapeutic benefit of talc. Treatment decisions must be individualized, weighing patient prognosis and performance status.
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