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Background <p>Talc slurry pleurodesis is widely used for malignant pleural effusion (MPE); however, its success rate ranges from 50 to 75%, and reliable predictors are lacking. This study aimed to identify predictors of pleural effusion control failure following pleurodesis and develop a short-term predictive scoring system.</p> Methods <p>We retrospectively analyzed 170 patients with MPE who underwent talc pleurodesis at a single center between 2014 and 2024. The cohort was divided into training (n = 136) and validation (n = 34) cohorts. Logistic regression was used to identify independent predictors of pleural effusion control failure within 30–90&#xa0;days.</p> Results <p>The most common primary tumors were lung, breast, and ovarian cancers. Pleural effusion was controlled in 70.6% of cases. Univariate analysis identified low body mass index, supportive care alone, Grade 2 collapse of the lower lung field post-drainage, extensive pulmonary consolidation, large tumor (≥ 7&#xa0;cm), hypoalbuminemia, and positive pleural fluid cytology (Class III or higher) to be associated with pleural effusion control failure. Multivariate analysis revealed that massive pleural effusion (<i>P</i> = 0.048), supportive care alone (<i>P</i> &lt; 0.001), and Grade 2 lung collapse (<i>P</i> = 0.003) were independent predictors of pleural effusion control failure. A scoring system incorporating these factors was validated in a validation cohort, demonstrating a control rate of approximately 90%, 60% and 30% in patients scoring ≤ 1, 2 and ≥ 3 points, respectively.</p> Conclusions <p>The scoring system may support early decision-making regarding talc pleurodesis and palliative strategies, potentially improving quality of life in patients with MPE.</p>

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Development and validation of a predictive model for pleural effusion control following talc pleurodesis in malignant pleural effusion

  • 期刊论文

  • 发表日期：

    2026年3月17日

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  • Shunya Hanawa,
  • Masaru Ejima,
  • Mari Sugawara,
  • Natsushi Kubota,
  • Rina Kato,
  • Kotaro Hanawa,
  • Seishi Higashi,
  • Satoko Hanada,
  • Reiko Taki

摘要

Background

Talc slurry pleurodesis is widely used for malignant pleural effusion (MPE); however, its success rate ranges from 50 to 75%, and reliable predictors are lacking. This study aimed to identify predictors of pleural effusion control failure following pleurodesis and develop a short-term predictive scoring system.

Methods

We retrospectively analyzed 170 patients with MPE who underwent talc pleurodesis at a single center between 2014 and 2024. The cohort was divided into training (n = 136) and validation (n = 34) cohorts. Logistic regression was used to identify independent predictors of pleural effusion control failure within 30–90 days.

Results

The most common primary tumors were lung, breast, and ovarian cancers. Pleural effusion was controlled in 70.6% of cases. Univariate analysis identified low body mass index, supportive care alone, Grade 2 collapse of the lower lung field post-drainage, extensive pulmonary consolidation, large tumor (≥ 7 cm), hypoalbuminemia, and positive pleural fluid cytology (Class III or higher) to be associated with pleural effusion control failure. Multivariate analysis revealed that massive pleural effusion (P = 0.048), supportive care alone (P < 0.001), and Grade 2 lung collapse (P = 0.003) were independent predictors of pleural effusion control failure. A scoring system incorporating these factors was validated in a validation cohort, demonstrating a control rate of approximately 90%, 60% and 30% in patients scoring ≤ 1, 2 and ≥ 3 points, respectively.

Conclusions

The scoring system may support early decision-making regarding talc pleurodesis and palliative strategies, potentially improving quality of life in patients with MPE.