Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa493
D. Fitzgerald, S. Muruganandan, C. Stanley, A. Badiei, K. Murray, C. Read, Y. C. Lee
Traditionally, most patients with malignant pleural effusion (MPE) have to undergo fluid drainage to assess if the underlying lung expands (or not) before being offered either pleurodesis or indwelling pleural catheter (IPC) respectively. Recent data suggest that talc can be safely instilled via IPC. Using IPC as a first-line definitive therapy for all MPE patients, followed by talc if suitable, will suit both subgroups and remove the need for prior assessment of expansion. This observational study enrolled 102 consecutive patients with symptomatic MPE (68% male) to assess the feasibility of EPIToME, a clinical algorithm incorporating results from AMPLE-1, -2, TIME-2, ASAP and IPC-Plus trials. All patients had IPC inserted and fluid evacuated. Those whose lung adequately expanded (n=47) underwent talc instillation and were discharged with daily vacuum drainages for 14 days or until pleurodesed. Using this protocol, 74% achieved pleurodesis after a median of 20 days. Patients unsuitable for talc pleurodesis (n=55) – trapped lung (n=31), prior failed pleurodesis, patient/oncologist preference - were discharged with symptom-guided drainage. All were followed for ≥120 days or till death. Only one patient needed further pleural drainage for fluid control in the first 12 months. Complications included symptomatic loculation (10%), IPC infection (7%) and reversible IPC blockage (3%). Conclusion: A high percentage of patients in the real-world unselected MPE population were not suitable for talc and first-line IPC offered optimal care. For those eligible, IPC combined with inpatient talc slurry pleurodesis, followed by daily home drainage provided good success rates.
{"title":"EPIToME (Early Pleurodesis via IPC with Talc for Malignant Effusion): Evaluation of a new management algorithm","authors":"D. Fitzgerald, S. Muruganandan, C. Stanley, A. Badiei, K. Murray, C. Read, Y. C. Lee","doi":"10.1183/13993003.congress-2019.oa493","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa493","url":null,"abstract":"Traditionally, most patients with malignant pleural effusion (MPE) have to undergo fluid drainage to assess if the underlying lung expands (or not) before being offered either pleurodesis or indwelling pleural catheter (IPC) respectively. Recent data suggest that talc can be safely instilled via IPC. Using IPC as a first-line definitive therapy for all MPE patients, followed by talc if suitable, will suit both subgroups and remove the need for prior assessment of expansion. This observational study enrolled 102 consecutive patients with symptomatic MPE (68% male) to assess the feasibility of EPIToME, a clinical algorithm incorporating results from AMPLE-1, -2, TIME-2, ASAP and IPC-Plus trials. All patients had IPC inserted and fluid evacuated. Those whose lung adequately expanded (n=47) underwent talc instillation and were discharged with daily vacuum drainages for 14 days or until pleurodesed. Using this protocol, 74% achieved pleurodesis after a median of 20 days. Patients unsuitable for talc pleurodesis (n=55) – trapped lung (n=31), prior failed pleurodesis, patient/oncologist preference - were discharged with symptom-guided drainage. All were followed for ≥120 days or till death. Only one patient needed further pleural drainage for fluid control in the first 12 months. Complications included symptomatic loculation (10%), IPC infection (7%) and reversible IPC blockage (3%). Conclusion: A high percentage of patients in the real-world unselected MPE population were not suitable for talc and first-line IPC offered optimal care. For those eligible, IPC combined with inpatient talc slurry pleurodesis, followed by daily home drainage provided good success rates.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83368445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa3086
A. Forster, A. Leitch
{"title":"An assessment of treatment decisions and patient outcomes in Pleural Service users based on age and performance status, at the Western General Hospital, in Edinburgh","authors":"A. Forster, A. Leitch","doi":"10.1183/13993003.congress-2019.pa3086","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa3086","url":null,"abstract":"","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81804452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa3092
R. Mercer, C. Wigston, R. Banka, Maged Hassan, R. Asciak, E. Bedawi, D. McCracken, R. Hallifax, N. Rahman
{"title":"Systematic review of the management of Solitary Fibrous Tumours of the Pleura (SFTP)","authors":"R. Mercer, C. Wigston, R. Banka, Maged Hassan, R. Asciak, E. Bedawi, D. McCracken, R. Hallifax, N. Rahman","doi":"10.1183/13993003.congress-2019.pa3092","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa3092","url":null,"abstract":"","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79956033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa3094
I. Rodrigues, L. Nascimento, T. Gomes, Sara Heleno, A. C. Pimenta, B. Conde, A. Fernandes
Introduction: Thymic Epithelial Tumours (TET) represent a group of rare primary tumours of the mediastinum, and include Thymomas and Thymic Carcinomas. Objectives: Describe demographics, clinical presentation, staging and survival of patients diagnosed with TET; compare our results with current ESMO guidelines for TET (2015). Methods: Retrospective analysis of medical records of patients diagnosed with thymic tumours, followed in our pneumology department, between 1999 and 2019. Results: We identified 30 patients, of which 3 were excluded for not meeting the definition of TET (two were neuroendocrine thymic tumours and one a thymolipoma). Of the remaining 27, 59.3% were males, mean age 64.4±2.28 years. Most patients (85.2%) had no smoking habits and 63% had no significant comorbidities. Previous malignancy was reported in only 11.1%. Auto-immune disorders were present in a third of the patients; of those, 77.7% presented with myasthenia gravis and 11.1% with one of the following: red cell aplasia, thyroiditis, Good syndrome, cerebellar degeneration. Nonspecific respiratory symptoms were present in 55.5%. The most frequent histopathological type, according to the World Health Organisation classification, was B1 (22.2%), followed by AB, B2 and C (18.5% each). Regarding the Masaoka-Koga classification, 29.6% patients were in stage I and another 29.6% in stage IVA. Eighteen patients underwent surgery. 5-year overall survival was 75%, and progression of the disease occurred in 6 cases. Discussion and Conclusions: In comparison to the guidelines, our sample had a higher proportion of males, higher mean age and higher incidence of advanced disease, which resulted in a lower 5-year survival.
{"title":"Thymic epithelial tumours – a retrospective analysis of 20 years in a Portuguese pneumology department","authors":"I. Rodrigues, L. Nascimento, T. Gomes, Sara Heleno, A. C. Pimenta, B. Conde, A. Fernandes","doi":"10.1183/13993003.congress-2019.pa3094","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa3094","url":null,"abstract":"Introduction: Thymic Epithelial Tumours (TET) represent a group of rare primary tumours of the mediastinum, and include Thymomas and Thymic Carcinomas. Objectives: Describe demographics, clinical presentation, staging and survival of patients diagnosed with TET; compare our results with current ESMO guidelines for TET (2015). Methods: Retrospective analysis of medical records of patients diagnosed with thymic tumours, followed in our pneumology department, between 1999 and 2019. Results: We identified 30 patients, of which 3 were excluded for not meeting the definition of TET (two were neuroendocrine thymic tumours and one a thymolipoma). Of the remaining 27, 59.3% were males, mean age 64.4±2.28 years. Most patients (85.2%) had no smoking habits and 63% had no significant comorbidities. Previous malignancy was reported in only 11.1%. Auto-immune disorders were present in a third of the patients; of those, 77.7% presented with myasthenia gravis and 11.1% with one of the following: red cell aplasia, thyroiditis, Good syndrome, cerebellar degeneration. Nonspecific respiratory symptoms were present in 55.5%. The most frequent histopathological type, according to the World Health Organisation classification, was B1 (22.2%), followed by AB, B2 and C (18.5% each). Regarding the Masaoka-Koga classification, 29.6% patients were in stage I and another 29.6% in stage IVA. Eighteen patients underwent surgery. 5-year overall survival was 75%, and progression of the disease occurred in 6 cases. Discussion and Conclusions: In comparison to the guidelines, our sample had a higher proportion of males, higher mean age and higher incidence of advanced disease, which resulted in a lower 5-year survival.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"371 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78355350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa3800
Irene Gerogianni, R. Jagirdar, E. Pitaraki, Olympia A Kouliou, C. Hatzoglou, K. Gourgoulianis, Sotiris Zaroginannis
{"title":"Effects of 2-Deoxy-glucose (2DG) with cisplatin and pemetrexed in mesothelioma cell mediated collagen gel contraction","authors":"Irene Gerogianni, R. Jagirdar, E. Pitaraki, Olympia A Kouliou, C. Hatzoglou, K. Gourgoulianis, Sotiris Zaroginannis","doi":"10.1183/13993003.congress-2019.oa3800","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa3800","url":null,"abstract":"","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72733575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa3797
E. Janssens, J. Meerbeeck, K. Lamote
{"title":"Exploration of breath analysis to monitor therapeutic response in mesothelioma patients","authors":"E. Janssens, J. Meerbeeck, K. Lamote","doi":"10.1183/13993003.congress-2019.oa3797","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa3797","url":null,"abstract":"","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74211650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa3095
M. Dąbrowska, K. Faber, Martyna Tandejko-Burdyna, P. Korczyński, R. Krenke
Introduction: Mediastinal lymphadenopathy (ML), may be caused either by malignant or benign diseases. It usually is diagnosed by chest computed tomography and bronchoscopy with endobronchial ultrasound guided TBNA (EBUS-TBNA). Aim: The aim of the study was to analyze causes of ML in patients, in whom bronchoscopy with EBUS-TBNA was performed. Patients and Methods: A retrospective analysis of all patients, who had ML and underwent bronchoscopy with EBUS-TBNA between 2009 and 2017 was performed. Results: 1075 (596 M, 479 F) patients who underwent EBUS-TBNA were included in the analysis. The most common cause of ML were malignant diseases (n=662, 61.6%). Lung cancer was diagnosed in 572 (53%) patients, while 90 (8.4%) patients had other malignancies. Non-malignant diseases were diagnosed in 356 (33.1%) patients. In this group the most common diagnosis was sarcoidosis -250 patients (23.3%). Infectious diseases were documented in 32 cases (3%) and included: tuberculosis (17), MOTT (2), pneumoniae (10), pulmonary invasive mycosis (2) and mononucleosis (1). In 51 (4.7%) patients ML was associated with heart failure. 23 patients (2.1%) had other diseases that could have explained ML (among them interstitial lung diseases were the most common). In 57 (5.3%) etiology of ML could not have been determined due to lack of pathologic diagnosis or follow-up. Conclusions: The most common cause of ML were malignant diseases. Sarcoidosis and HF accounted for the majority of benign ML causes, while infections only occasionally were diagnosed as the cause of ML.
{"title":"Etiology of mediastinal lymph node enlargement in patients who underwent EBUS-TBNA","authors":"M. Dąbrowska, K. Faber, Martyna Tandejko-Burdyna, P. Korczyński, R. Krenke","doi":"10.1183/13993003.congress-2019.pa3095","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa3095","url":null,"abstract":"Introduction: Mediastinal lymphadenopathy (ML), may be caused either by malignant or benign diseases. It usually is diagnosed by chest computed tomography and bronchoscopy with endobronchial ultrasound guided TBNA (EBUS-TBNA). Aim: The aim of the study was to analyze causes of ML in patients, in whom bronchoscopy with EBUS-TBNA was performed. Patients and Methods: A retrospective analysis of all patients, who had ML and underwent bronchoscopy with EBUS-TBNA between 2009 and 2017 was performed. Results: 1075 (596 M, 479 F) patients who underwent EBUS-TBNA were included in the analysis. The most common cause of ML were malignant diseases (n=662, 61.6%). Lung cancer was diagnosed in 572 (53%) patients, while 90 (8.4%) patients had other malignancies. Non-malignant diseases were diagnosed in 356 (33.1%) patients. In this group the most common diagnosis was sarcoidosis -250 patients (23.3%). Infectious diseases were documented in 32 cases (3%) and included: tuberculosis (17), MOTT (2), pneumoniae (10), pulmonary invasive mycosis (2) and mononucleosis (1). In 51 (4.7%) patients ML was associated with heart failure. 23 patients (2.1%) had other diseases that could have explained ML (among them interstitial lung diseases were the most common). In 57 (5.3%) etiology of ML could not have been determined due to lack of pathologic diagnosis or follow-up. Conclusions: The most common cause of ML were malignant diseases. Sarcoidosis and HF accounted for the majority of benign ML causes, while infections only occasionally were diagnosed as the cause of ML.","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88948451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa3090
K. Athanassiadi, E. Liverakou, D. Magouliotis, A. Katsandri, C. Vourlakou, Eleni Testebasi
{"title":"Core cutting needle biopsy of anterior mediastinal tumors : Do we really need Chest Tomographic Scan to proceed?","authors":"K. Athanassiadi, E. Liverakou, D. Magouliotis, A. Katsandri, C. Vourlakou, Eleni Testebasi","doi":"10.1183/13993003.congress-2019.pa3090","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa3090","url":null,"abstract":"","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79975971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa3089
Damian Dooey, L. William, Andrew Cheng, N. Nasir, M. Babores, T. Nagarajan
{"title":"Lymphocytic Pleural Effusions: Aetiology and Frequency in a UK District General Hospital","authors":"Damian Dooey, L. William, Andrew Cheng, N. Nasir, M. Babores, T. Nagarajan","doi":"10.1183/13993003.congress-2019.pa3089","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa3089","url":null,"abstract":"","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"348 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79711601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa489
A. Koulelidis, S. Anevlavis, Nikolaos Nikitidis, P. Ntolios, S. Eleftheriadis, M. Froudarakis
{"title":"Local anesthesia by lidocaine versus lidocaine and midazolam in medical thoracoscopy","authors":"A. Koulelidis, S. Anevlavis, Nikolaos Nikitidis, P. Ntolios, S. Eleftheriadis, M. Froudarakis","doi":"10.1183/13993003.congress-2019.oa489","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa489","url":null,"abstract":"","PeriodicalId":20113,"journal":{"name":"Pleural and Mediastinal Malignancies","volume":"273 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75924797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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