Response

Our plain-English summary of Response, by R. Thomas, Y.C.G. Lee (Chest, 2014).

The study

• Authors: R. Thomas, Y.C.G. Lee
• Journal: Chest
• Published: 2014;146(3):e111-e112
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This was a letter to the editor. The authors replied to a letter from Bertolaccini and colleagues about the authors' own earlier study of cancer spreading along the tract of indwelling pleural catheters, which are drainage tubes left in the chest. In their series of 110 catheter insertions for malignant effusion drainage, the overall rate of catheter tract metastasis was 10%. It complicated nine of the 66 catheters (13.6%) placed in mesothelioma patients. Tract metastasis often developed late, at a median of 281 days (range 58 to 694 days) after insertion. In their analysis, the length of survival after insertion was the only significant independent risk factor (multivariate odds ratio 2.495; 95% confidence interval 1.247 to 4.993). The authors noted, however, that survival is notoriously hard to predict for individual mesothelioma patients. None of the six patients in their study had adverse events from radiotherapy given for tract metastasis, and the catheter did not need to be removed during treatment. The authors concluded that routine preventive radiotherapy after catheter insertion should not be recommended on the available evidence. The letter does not discuss asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor (reply to correspondence) summarizing data from the authors' earlier case series of indwelling pleural catheter insertions
• Who was studied: 110 indwelling pleural catheter insertions for malignant pleural effusion drainage, 66 of them in mesothelioma patients (Perth, Australia); dates not given in the letter
• Exposure: Insertion of an indwelling pleural catheter. No asbestos or fiber exposure is discussed.
• Main results:
  • Overall incidence of catheter tract metastasis across all 110 insertions was 10%
  • Among mesothelioma patients, catheter tract metastasis complicated 9 of 66 catheters (13.6%)
  • Catheter tract metastasis often developed late after insertion: median 281 days, range 58 to 694 days
  • Survival interval after catheter insertion was the sole significant independent risk factor for catheter tract metastasis (multivariate OR 2.495; 95% CI 1.247 to 4.993)
  • None of the six patients given radiotherapy for catheter tract metastasis had adverse events, and the catheter did not need to be removed during radiotherapy
• The authors' conclusion: The authors concluded that routine prophylactic radiotherapy after catheter insertion should not be recommended based on the available evidence.
• Limitations the authors state:
  • The authors noted that, although survival interval was the only significant risk factor, survival is notoriously hard to predict for individual mesothelioma patients, and no predictors exist to identify high-risk patients

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Related studies

• Catheter tract metastasis associated with indwelling pleural catheters — R. Thomas, C.A. Budgeon, et al. (2014)
• To seed or not to seed: the open question of mesothelioma intervention tract metastases — L. Bertolaccini, A. Viti, et al. (2014)
• Aggressive versus symptom-guided drainage of malignant pleural effusion via indwelling pleural catheters (AMPLE-2): an open-label randomised trial — S. Muruganandan, M. Azzopardi, et al. (2018)
• Intrapleural Fibrinolysis for the Treatment of Indwelling Pleural Catheter-Related Symptomatic Loculations: A Multicenter Observational Study — R. Thomas, F. Piccolo, et al. (2015)
• Interventional therapies for malignant pleural effusions: the present and the future — R. Thomas, R. Francis, et al. (2014)
• Protocol of the Australasian Malignant Pleural Effusion-2 (AMPLE-2) trial: a multicentre randomised study of aggressive versus symptom-guided drainage via indwelling pleural catheters — M. Azzopardi, R. Thomas, et al. (2016)

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