Next Article in Journal
The Scottish Intercollegiate Guidelines Network (SIGN) 157: Guidelines on Risk Reduction and Management of Delirium
Previous Article in Journal
Cardiovascular and Metabolic Consequences of Liver Transplantation: A Review
Open AccessReview

Malignant Pleural Effusion and Its Current Management: A Review

1
Faculty of Medicine, University of Maribor, Institute of Biomedical Sciences, Taborska Ulica 8, SI-2000 Maribor, Slovenia
2
Faculty of Medicine, University of Maribor, Taborska Ulica 8, SI-2000 Maribor, Slovenia
3
Department of thoracic surgery, University Medical Centre Maribor, Ljubljanska 5, SI-2000 Maribor, Slovenia
*
Authors to whom correspondence should be addressed.
Medicina 2019, 55(8), 490; https://doi.org/10.3390/medicina55080490
Received: 23 June 2019 / Revised: 17 July 2019 / Accepted: 12 August 2019 / Published: 15 August 2019
PDF [8574 KB, uploaded 21 August 2019]
  |  

Abstract

Malignant pleural effusion (MPE) is an exudative effusion with malignant cells. MPE is a common symptom and accompanying manifestation of metastatic disease. It affects up to 15% of all patients with cancer and is the most common in lung, breast cancer, lymphoma, gynecological malignancies and malignant mesothelioma. In the last year, many studies were performed focusing on the pathophysiological mechanisms of MPE. With the advancement in molecular techniques, the importance of tumor-host cell interactions is becoming more apparent. Additionally, the process of pathogenesis is greatly affected by activating mutations of EGFR, KRAS, PIK3CA, BRAF, MET, EML4/ALK and RET, which correlate with an increased incidence of MPE. Considering all these changes, the authors aim to present a literature review of the newest findings, review of the guidelines and pathophysiological novelties in this field. Review of the just recently, after seven years published, practice guidelines, as well as analysis of more than 70 articles from the Pubmed, Medline databases that were almost exclusively published in indexed journals in the last few years, have relevance and contribute to the better understanding of the presented topic. MPE still presents a severe medical condition in patients with advanced malignancy. Recent findings in the field of pathophysiological mechanisms of MPE emphasize the role of molecular factors and mutations in the dynamics of the disease and its prognosis. Treatment guidelines offer a patient-centric approach with the use of new scoring systems, an out of hospital approach and ultrasound. The current guidelines address multiple areas of interest bring novelties in the form of validated prediction tools and can, based on evidence, improve patient outcomes. However, the role of biomarkers in a clinical setting, possible new treatment modalities and certain specific situations still present a challenge for new research.
Keywords: thoracic surgery; malignant pleural effusion; lung cancer; breast cancer; pleural carcinosis; treatment guidelines; LENT score thoracic surgery; malignant pleural effusion; lung cancer; breast cancer; pleural carcinosis; treatment guidelines; LENT score
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Skok, K.; Hladnik, G.; Grm, A.; Crnjac, A. Malignant Pleural Effusion and Its Current Management: A Review. Medicina 2019, 55, 490.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Medicina EISSN 1010-660X Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top