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Αλέξανδρος Γ. Σφακιανάκης

Monday, June 28, 2021

Systemic Inflammatory Response to Different Sclerosing Agents as a Predictor of Pleurodesis Outcome

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In Vivo. 2021 Jul-Aug;35(4):2391-2398. doi: 10.21873/invivo.12516.

ABSTRACT

BACKGROUND/AIM: The objectives of this study were to evaluate systemic inflammation using different sclerosing agents and to estimate the prediction of systemic inflammation for the efficacy of pleurodesis.

PATIENTS AND METHODS: Ninety-six patients with recurrent and symptomatic malignant pleural effusion were enrolled in this retrospective study. We used serum C-reactive protein (CRP) levels, serum leukocyte counts and neutrophil-to-lymphocyte ratios (NLRs) as parameters of systemic inflammatory reactions. Evaluations of these parameters were performed before and 24 h after pleurodesis.

RESULTS: Pleurodesis was successful in 81 (84.4%) patients. The non-graded talc induced the highest changes in serum CRP levels, total white blood cell and neutrophil counts compared to other agents, while mitoxantrone induced the lowest. Graded talc and bleomycin i nduced the same levels of changes in serum CRP levels and serum leukocyte counts. The change in serum NLR was the same for all agent groups. Logistic regression confirmed that a change in serum CRP levels [odds ratio (OR)=0.92, p=0.002] and previous chemotherapy (OR=3.31, p=0.012) were independent predictors of pleurodesis efficacy.

CONCLUSION: Pleurodesis agents induced a systemic inflammatory response at different levels. The change in serum CRP levels could be useful for predicting the success of pleurodesis.

PMID:34182522 | DOI:10.21873/invivo.12516

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