Arellano-Orden E, et al. - Researchers enquired regarding the changes in pleural fluid survivin concentrations induced by talc instillation into the pleural space in patients with malignant pleural effusion. They also inspected the changes in association with pleurodesis outcome and patient survival. The inference drawn was that elevated pleural fluid survivin concentrations were beneficial for speculating the failure of pleurodesis. These were connected with shorter survival in patients with malignant pleural effusion.

Methods

• Eligible candidates included 84 patients with malignant pleural effusion who underwent talc pleurodesis.
• Among them, 32 had breast cancer, 25 lung cancer and 27 had mesothelioma.
• Serial samples were extracted of pleural fluid prior to thoracoscopy (baseline) and 24 hours thereafter.

Results

• It was noted that survivin levels were successfully quantified in all pleural fluid samples, and they were considerably higher in samples obtained after thoracoscopic talc poudrage compared with baseline (P < .001).
• A markedly poorer pleurodesis outcome (P=.004) was reported in subjects with higher pleural fluid survivin levels at baseline.
• Findings demonstrated that a 30 pg/mL cut-off for baseline survivin in pleural fluid speculated failure of pleurodesis with a 54% sensitivity and 79% specificity (P=.009).
• Data exhibited that median postpleurodesis survival of patients with baseline survivin levels ≥30 pg/mL was 4 months (range: 0.1-38) vs 13 months (range: 0.1-259) in patients below that cut-off (P < .001).