Survival of non small cell lung carcinoma patients with malignant pleural effusions

Background: Lung cancer is the most common cause of the malignant pleural effusions(MPE).For patients with lung cancer and MPE, the median survival is only 3-4 months.The aim of this study was evaluate the lung cancer patients with MPE clinical and laboratory findings on admission,analysis of 2 years survival and prognostic factors. Methods: Between 2008-2011, the retrospective cohort study was done in Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital and 199 cases of non small cell lung carcinoma with MPE were examined. Results: 139(69.8%) male and 60(30.2%) female patients with median age of 64 years were included in the study.Median overal survival for patients were 4.2 months.Adenocarcinoma was found the leading cause MPE with 80.4%. 167(83.9%) had MPE at initial diagnosis,32(16.1%) developed malign pleural effusions disease progression.Factors affecting mortality with univariate analysis included: gender(p<0.001),MPE with distant metastasis(p:0.025),lower serum albumin(p<0.0001),lower pleural protein(p<0.0001),increased serum LDH(p:0.003),increased serum CRP(p<0.0001),increased white blood cells(p<0.0001),smoking behavior(p:0.023),squamous cell carcinoma(p:0.004),and treatment decision(p<0.0001).Multivariate analysis revealed that patients who have high level of serum CRP(p:0.017),lower serum albumin(p:0.009),lower pleural protein(p:0.003),MPE with distant metastasis(p:0.003) and did not receive chemotherapy(p<0.0001) had shorter survival. Conclusion: High level of serum CRP,lower serum albumin,lower pleural protein,MPE with distant metastasis were determined to be the most important prognostic factors for non small cell lung carcinoma patients with MPE.