Malignant Pleural Effusions: Management Options

David J. McCracken, MRCP; Jose M. Porcel, MD; Najib M. Rahman, DPhil


Semin Respir Crit Care Med. 2018;39(6):704-712. 

In This Article


MPE remains a significant clinical problem resulting in substantial health care burden including inpatient stay and cost. Median survival and prognosis are limited, and all interventions should be considered with a palliative perspective.

Several methods are available in the management of MPE including IPCs and traditional chest drainage and talc pleurodesis. The popularity of IPCs has risen significantly over recent times, cementing their position in clinical practice as joint first choice treatment option, although difficulties still remain.

Despite the availability of multiple new and emerging techniques, patient selection and predicting treatment success remain difficult due to complications such as unexpandable lung and multiloculated effusions.

The poor prognosis and palliative outlook from MPE means that future studies should be measured using patient-centered outcomes wherever possible.