Management of malignant pleural effusions.

PURPOSE OF REVIEW: Malignant pleural effusions (MPEs) are one of the most common problems faced by clinicians and, since there is no optimum treatment available, they deserve efforts aimed to improve their management.

RECENT FINDINGS: We have reviewed the most recent articles regarding treatment of MPE, with special emphasis on pleurodesis and indwelling pleural catheter placement. Although iodopovidone, silver nitrate and doxycycline are useful, talc continues to be the most effective agent available for pleurodesis. Use of calibrated talc with large particle size is now firmly established, in order to prevent complications. Indwelling pleural catheters are gaining general acceptance, and they are currently a valid option for patients with lung entrapment or those who have a previous failed pleurodesis. Advances in translational medicine related to this topic are also described.

SUMMARY: The above results may contribute to improve significantly management of patients with malignant pleural effusions, especially those with advanced disease who are not suitable for pleurodesis procedures.