{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:21:42Z","timestamp":1755796902681,"version":"3.41.2"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T00:00:00Z","timestamp":1518480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Neumosur foundation","award":["13\/2013"],"award-info":[{"award-number":["13\/2013"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Survivin is a well\u2010known member of the inhibitor of apoptosis family, and has been related to increased tumour aggressivity, both in tissue and in pleural fluid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In patients with malignant pleural effusion, we sought to investigate the changes in pleural fluid survivin concentrations induced by talc instillation into the pleural space. Those changes were also examined in relation to pleurodesis outcome and patient survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated 84 patients with malignant pleural effusion who underwent talc pleurodesis. Of them, 32 had breast cancer, 25 lung cancer and 27 had mesothelioma. Serial samples of pleural fluid were obtained before thoracoscopy (baseline) and 24 hours thereafter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Survivin levels were successfully quantified in all pleural fluid samples, and they were significantly higher in samples obtained after thoracoscopic talc poudrage compared with baseline (<jats:italic>P<\/jats:italic> &lt; .001). Patients with higher pleural fluid survivin levels at baseline had a significantly poorer pleurodesis outcome (<jats:italic>P<\/jats:italic> = .004). A 30 pg\/mL cut\u2010off for baseline survivin in pleural fluid predicted failure of pleurodesis with a 54% sensitivity and 79% specificity (<jats:italic>P<\/jats:italic> = .009). Moreover, median postpleurodesis survival of patients with baseline survivin levels \u226530 pg\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> was 4 months (range: 0.1\u201038), compared with 13 months (range: 0.1\u2010259) in patients below that cut\u2010off (<jats:italic>P<\/jats:italic> &lt; .001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated pleural fluid survivin concentrations are useful to predict failure of pleurodesis and are associated with shorter survival in patients with malignant pleural effusion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.12895","type":"journal-article","created":{"date-parts":[[2018,1,23]],"date-time":"2018-01-23T07:06:34Z","timestamp":1516691194000},"source":"Crossref","is-referenced-by-count":6,"title":["Survivin is a negative prognostic factor in malignant pleural 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M\u00e9dico\u2010Quir\u00fargica de Enfermedades Respiratorias Hospital Universitario Virgen del Roc\u00edo\/Universidad de Sevilla Seville Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Mart\u00edn\u2010Juan","sequence":"additional","affiliation":[{"name":"Instituto de Biomedicina de Sevilla (IBiS) Unidad M\u00e9dico\u2010Quir\u00fargica de Enfermedades Respiratorias Hospital Universitario Virgen del Roc\u00edo\/Universidad de Sevilla Seville Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Rodr\u00edguez\u2010Panadero","sequence":"additional","affiliation":[{"name":"Instituto de Biomedicina de Sevilla (IBiS) Unidad M\u00e9dico\u2010Quir\u00fargica de Enfermedades Respiratorias Hospital Universitario Virgen del Roc\u00edo\/Universidad de Sevilla Seville Spain"},{"name":"CIBER de Enfermedades Respiratorias (CIBERES) Instituto de Salud Carlos III Madrid 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