A multi-disciplinary Task Force of respiratory experts has published a new statement document to guide best practice in the management of malignant pleural effusions (MPE).
The statement is published in the European Respiratory Journal, and was developed through a collaborative ERS / European Association for Cardio-Thoracic Surgery (EACTS) Task Force, which included nine respiratory physicians and five thoracic surgeons from nine different European countries.
The aim of the Task Force was to develop a statement that represented a comprehensive, expert scientific review of the literature, identified by systematic searches with conclusions supported by accompanying references, which may be relevant to respiratory physicians, thoracic surgeons and oncologists in routine clinical practice.
A total of six clinical questions are addressed in the statement, focusing on:
- symptomatic MPE;
- MPE with trapped lung;
- loculated MPE;
- factors predicting prognosis;
- whether oncological therapy should precede definitive fluid management in treatment-sensitive tumours;
- whether histological diagnosis is always required
The authors say that the management of MPE has advanced significantly since the most recent international guidelines were published, with several high-quality randomised controlled trials providing robust evidence to inform clinical practice.
However, a number of unanswered questions remain, and ongoing research is required in order for clinicians to provide optimal care for this patient group.