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I.R. Abreu
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P3.10 - Nursing/Palliative Care/Ethics (ID 726)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Nursing/Palliative Care/Ethics
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.10-001 - Prognostic Factors of Survival in Malignant Pleural Effusion (ID 9647)
09:30 - 09:30 | Author(s): I.R. Abreu
- Abstract
Background:
The aim of this study was to identify predictors of overall survival (OS) after pleural palliative procedures in patients with malignant pleural effusion (MPE).
Method:
Data was collected from our database between August 2013 and December of 2016 of patients with MPE. All patients were followed-up at least 30 days after the pleural procedure. Collected data included basic demographics, American Society of Anesthesiologists (ASA) physical status classification, performance status according to the Eastern Cooperative Oncology Group (ECOG) score, number of metastatic sites, hematological parameters, including white blood cells (WBC), number of neutrophils and lymphocytes, neutrophil/lymphocyte ratio (NLR), red blood cells (RBC) and platelets/lymphocyte ratio, in addition to body mass index (BMI) on the day before surgery. The influence of the primary tumor site was also assessed. During the period after the palliative procedure, we evaluated the volume of drained liquid, the type of palliative procedure performed, recurrence of pleural effusion, the presence of neoplastic cells in the pleural fluid, in addition to the biochemical profile including pleural fluid pH, levels of adenosine deaminase (ADA), total protein, albumin, glucose, lactate dehydrogenase (DHL) and the proportion of lymphocytes in pleural fluid. We also evaluated the presence of pleural thickening and pulmonary infiltrate through chest computed tomography. To analyze OS, patients were divided into two groups. Group I included OS greater than 30 days and Group II included OS shorter than 30 days. Prognostic factors for survival were identified by univariate analysis, using Fisher's exact and Student's T-Test. Subsequently, the significant variables were entered into a multivariate logistic regression analysis (p < 0.05).
Result:
A total of 208 patients were included in the analysis, 36,5% were male and the median age was 62 years. Median follow-up time for overall surviving was 127 days. The primary tumors were lung 39,9%, breast 29,3%, gastrointestinal 13%, gynecological 8,7% and others 9,1%. Factors affecting OS in univariate analysis were: procedure, ECOG, pulmonary infiltrate, albumin, protein, neutrophil, hematocrit and hemoglobin in peripheral blood. At the multivariate analysis, albumin (p=0.03), ECOG 3 e 4, hematocrit and pulmonary infiltrate with p<0.001 were identified as independents predictors of OS.
Conclusion:
Patients with MPE who presented pulmonary infiltrate, albumin < 2,5, hematocrit < 35, ECOG 3 and 4 were significantly associated with shorter survival. The identification of those prognostic factors may assist the choice of the optimal palliative support.
