Journal club

Abstract

Malignant pleural effusion (MPE) is a common problem in advanced malignancies and causes debilitating breathlessness leading to poor quality of life. There are two treatment options available to ‘definitively’ manage MPE which include chest drain with talc pleurodesis and indwelling pleural catheters (IPCs). Although both treatments have been in use for a long time, there has been limited research on the impact of these treatments on patient quality of life. Sivakumar and colleagues (Eur Respir J 2023, DOI: 10.1183/13993003.01215–2022) evaluated the impact of outpatient indwelling pleural catheter with talc slurry vs inpatient chest drain with talc pleurodesis on the quality of life of MPE patients in a multicentre, randomised controlled trial (OPTIMUM). This study was undertaken at 11 hospitals in the UK and one in Australia. 142 patients were randomised 1:1 to the IPC or chest drain. The primary outcome was global health status, measured by a validated EORTC-QLQ C-30 questionnaire at 30 days post-randomisation. An 8-point difference in the score was considered clinically meaningful. There was a statistically significant improvement in the global health status at 30-days in both IPC (mean difference 13.11 [95% CI 5.6 to 21.1]; p=0.001) and chest drain arms (mean difference …