What is the role of thoracentesis in the workup of small cell lung cancer (SCLC)?

Updated: May 07, 2021
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Answer

In small cell lung cancer (SCLC), the presence of malignant pleural effusion upstages the disease to extensive-stage SCLC. For adequate staging, pleural effusions should be aspirated and examined for malignant cells if no other sites of distant spread are identified.

If a large, symptomatic pleural effusion is present, therapeutic thoracentesis provides symptomatic relief. In patients with resistant, relapsed, or nonresponding disease, thoracentesis can be combined with pleurodesis to prevent recurrence of symptomatic effusions. The Cancer and Leukemia Group B (CALGB) reported similar outcomes in patients undergoing pleurodesis via use of talc slurry or poudrage. [32] The currently preferred agent for pleurodesis is sterilized talc, which can be instilled either as a slurry or as a powder during pleuroscopy.


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