The treatment of malignant pleural effusions

One hundred thirty‐three patients with 154 treated malignant pleural effusions were reviewed. Carcinoma of the breast, bronchogenic carcinoma, and lymphomas were the most frequent tumors causing malignant pleural effusion. Cytologies were positive in 67% of the 125 effusions examined. Local treatment consisted of thoracentesis, tube thoracostomy with or without nitrogen mustard instillation, irradiation, or pleurectomy. Patients were followed for recurrence of effusion and return of symptoms for an average of 6 1/2 months. Statistical analysis showed that 37% of 66 hemithoraces (60 patients) treated with tube thoracostomy and nitrogen mustard were free of effusion 3 months after treatment, and 29% 6 months after therapy. Fifty‐three percent of these patients were asymptomatic at 6 months, and 39% at 1 year after treatment. Thoracentesis with or without nitrogen mustard instillation was distinctly inferior to the tube and nitrogen mustard method. Pleurectomy in selected cases proved worthwhile.

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